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ATTACHMENT 1 <br /> CONSULTANT ' S APPLICATION FOR PAYMENT NO . for <br /> WORK ORDER No . 4 <br /> ENGINEER' S CERTIFICATION : <br /> THE UNDERSIGNED ENGINEER' S REPRESENTATIVE CERTIFIES that I have checked <br /> and verified the above Application for Payment No . and that to the best of my <br /> knowledge and belief, it is a true and correct statement of work performed and/or material <br /> supplied by the ENGINEER ; that all work and/or materials included in the Application for <br /> Payment have been inspected by me and/or by my duly authorized representative or <br /> assistants ; that it has been performed and/or supplied in full accordance with the <br /> requirements of the referenced Contract and with sound engineering practice and <br /> judgment ; and that the payment amount claimed and requested by the ENGINEER is <br /> correctly computed on the basis of work performed and/or materials supplied to date . <br /> THE UNDERSIGNED ENGINEER' S REPRESENTATIVE ALSO CERTIFIES that all <br /> previous progress payments received from the COUNTY on account of Work done under <br /> the Contract referred to above have been applied on account to discharge ENGINEER ' s <br /> legitimate obligations incurred in connection with Work covered by prior Applications for <br /> Payment numbered 1 through inclusive ; and if this is a Final Pay Request , I further <br /> certify that all persons doing work upon or furnishing materials or supplies for this project <br /> under this foregoing Contract have been paid in full . <br /> Dated <br /> ENGINEER : CARTER ASSOCIATES , INC . <br /> 1708 21 st Street <br /> Vero Beach , Florida 32960 <br /> ( 561 ) 5624191 <br /> ENGINEER' S REPRESENTATIVE : <br /> Name and Title : <br /> State of Florida . <br /> County of Indian River. <br /> Subscribed and sworn to before me this day of , 200 <br /> Notary Public <br /> My Commission expires : <br /> F:\Public Works\KeithM\Stmnwater Projects\East IRC\Contracts\Ccnsultant Contract with Carter & Associates\Wank Order No. 4 - Vortex <br /> Treatment Units\Wcrk Order #4 - Latest Version.doc <br /> 8 <br />