Laserfiche WebLink
SUBCONTRACTOR 'S PAYMENT REQUEST <br /> SUBMITTED BY : DERRICO CONSTRUCTION CORPORATION <br /> Post Office Box 361177 <br /> Melbourne, FL 32936- 1177 <br /> SUBMITTED TO : INDIAN RIVER COUNTY DEPARTMENT OF UTILITIES <br /> 1801 27th Street <br /> Vero Beach , FL 32960 <br /> PROJECT NAME : IRC - US1 from The South Relief Canal to 1500 Feet South of <br /> 9th Street SE ( Oslo Rd . ) Conflicts with FDOT Drainage <br /> DESCRIPTION : UCP #2952, WIP #47123536 -044699 -07522 <br /> PERIOD ENDING : March 31 , 2009 <br /> PAY REQUEST: #4 - Final <br /> ORIGINAL CONTRACT AMOUNT $ 1229231 .45 <br /> APPROVED CHANGE ORDERS $ 10 , 740 . 42 <br /> TOTAL REVISED CONTRACT $ 1321971 . 87 <br /> TOTAL COMPLETED TO DATE $ 132 , 971 . 87 <br /> MATERIALS STORED $ 0 . 00 <br /> TOTAL COMPLETED AND STORED $ 132 ,971 . 87 <br /> RETAINAGE ( 10 % ) $ 0 . 00 <br /> TOTAL EARNED LESS RETAINAGE $ 132 , 971 . 87 <br /> LESS BILLED ON PREVIOUS ESTIMATES $ 92 , 548 . 67 <br /> PAYMENT DUE $ 40 ,423.20 <br /> RELEASE <br /> The undersigned certifies that all material , labor or services for which payment is requested <br /> have been fully paid for ; and the above project cannot be liened or made claim to by <br /> anyone who has furnished material , labor or services to the undersigned ; and the <br /> undersigned hereby releases Indian River County <br /> from further liability for materials , labor or services furnished by the undersigned through this <br /> pay period . <br /> This release becomes in full force and effect upon receipt by the undersigned of the <br /> "current payment due" amount, shown above . <br /> Date : , � fir, DERRICO CONSTRUCTION CORPORATION <br /> John P . Robertson , President <br /> STATE OF FLORIDA <br /> COUNTY OF BREVARD <br /> The foregoing instrument was acknowledged before me this /1 day of 2009 by <br /> John P . Robertson , President of DERRICO CONSTRUCTION CORPORATION , a Florida <br /> corporation , on behalf of the corporation . He is personally known to me and did take an oath . <br /> My Commission Expires : <br /> AOTARY PUBLIC <br /> JEAN ROBERTSON <br /> MY COMMISSION # DD475901 <br /> off@ EXPIRES: Sept. 26, 2009 <br /> Oi A <br /> (407( 398-0153 Pr. ''")e Notary Service.com <br />