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Home My WebLink About2006-327 SECTION 00942 - Change Order Form No . 7 goo - 3 a7 DATE OF ISSUANCE : 08/18/06 EFFECTIVE DATE: 09/05/06 OWNER : Indian River County CONTRACTOR Summit Construction Management, Inc . Contract : Project : Utilities Operations Complex OWNER's Contract No . 6037 ENGINEER's Contract No . 6037 ENGINEER Brown and Caldwell You are directed to make the following changes in the Contract Documents: Description : Close out of Line Item #5 Permit Allowance -- $(1 ,396.71 ) Close out of Line Item #8 Work Change Directive Allowance -- $(385 .52) Differential cost for larger trees required to obtain CO-- $3 ,402 .00 Total Cost of Change Order $ 1 , 619. 77 Additional time required to install standby power generators due to delays in shipping units . Reason for Change Order: Final close out of allowance items and Owner requested field changes . Attachments : (List documents supporting change) See attached reconciliation cost estimates and proposal from Summit Construction CHANGE IN CONTRACT CHANGE IN CONTRACT PRICE: TIMES Description Amount Description Time Original Contract Price $5. 148. 921 Original Contract Time: (days or dates) Substantial Completion : 300 Final Completion : 345 Net Increase ( Decrease) from $(381 ,542) Net change from previous previous Change Orders No. 0 to Change Orders No. 0 to 6 : (days) 6: Substantial Completion : 132 Final Completion: 132 Contract Price prior to this $4.767,379 Contract Time prior to this Change Order: Change Order: (days or dates) Substantial Completion : 432 Final Completion : 477 Net increase (decrease) of this $1 .619.77 Net increase (decrease) this Change Order: Change Order: (days or dates) Substantial Completion : 30 Final Completion : 90 Contract Price with all approved4.768.998.77 Contract Time with all approved Change Orders: Change Orders: (days or dates) Substantial Completion : 462 . Final Completion : 567 < ACCEPTED : ENDE : APPROVEDf r Brad Schu JamesIA. Niss ,� B hur R. N r By: CONTRACTOR (Signature) efl INEER (Signature) OWNER (Sign 8,7, Date : ( Lt / 06 Date : 08/18/06 Date : 09 / 19 /06 Summit Change Order No. 7_red2 00942 - 1 vull i , vV V1. VV�! VIII mLy / / L / y4LVtlI P .L bL Summit onstruction Management, Inc . Summ g CGCA58845 320043rd Ave .1Suke 11 , Vem Beach, Ft. 32960 i PROPOSAL TO: Indian River County PROJE& NAME: I.R. C. Utilities Operations Complex #UCP 2229 PROJEC'� ADDRESS: 4350 41 "` Street, Vero Beach PROPOSAL DATE: June 19, 2006 The scopeof this proposal will include the followinz: COST REMAINING IN ALLOWANCE ITEMS, FOR CREDIT CHANGE ORDER TO OWNER: Line Item #5 Permit Allowance $ 7,500. 00 Allowance Actual coc f 6. 103 .29 Cost remaining, credit to Owner $ 1 ,396.71 Line Item #8 Change Directive Allowance $94,600. 00 Actual cost, Change Directive #1 — 30 94214.48 Cost remaining, credit to Owner $ 385.52 Summit Construction Management, Inc. will provide the above scope of work for a total proposed cost of: TOTAL PROPOSAL COST: $ -11782.23 ago r/.�S 8 ( z4lOfD Phone (561) "H4.2099 Fa (561) 794-2097 run i .i vv v-r.wY viino�y / / L / `J4LuJ / P.J J.. 8 Change Directive Allowance $19,670.44 $19,670.44 1 Fire Suppression system $3,818.00 2 (Utoo Menanine $33,879. 10 3 E�IsctrcnlcOper. Door *6 $1 ,910.00 4 lfbandon Flow Wells $2,964.00 5 fJdmin Bldg flooring $7,750.01) t !min Bdg flooring $7,950.00 6 tanto Bldg add ffoor drain $325.66 7 / min Bldg add mason walls $2,932.00 Admin Bldg add mason walls -$195.00 iidmin Bldg delete frame walls $975.00 8 Admin Bldg stucco changes $10x400,00 9 Fmin Bldg add TV/elect outlt $150.00 10 r dd site conduit for Security $8,233.55 11 Mmin Bldg data conduit $3,439.97 12 iydmin Bldg increase AC slab $21100.00 iidmin Bldg conduit for gen $90828 ;ydmin Bldg relocate ref lines $2,759.00 13 jidd conduit to 41 at Street $1 ,400.00 14 Use interchcore key system $11480-00 ,iub Total No. 1 $74,929.56 15 AWmin . Building - Obscure Glass $325.00 16 ;ydmin . Building - Fled. Outlet in C $365.00 17 r.i Varehouse - wood gate at recelvir $30923 18 il dmin- Bldg. - Change FI Foil Insu $2,275.00 19 . to - add site light fixtures $7,778.27 20 ( elated 21 Its - add curbrincrease width of s $1 ,967.00 22 Iiielacata louver, add hoods at othe $660.00 23 :3fte - addsite light fixture cncrete $995.00 24c circuitry charges In Wereh $1 ,669.00 25f)elete irrigation at Right of Way -$4,500.00 26 ,}}dmtn. Building - Add N brackets $2,125.00 27 Ararshouse - Extra cost from Getc $21691 .42 28 ' arehouse - Charges paint color 5696.00 29 ; Ito - Add two feet to South dump! $525.00 Sub Total No. 2 $17,709.92 previous Total $92,639.48 30 hstall 700' of irrigation mainline $1 ,575.00 $rand Total $94,214.48 'remaining Balance $385.52 Summit Coustruction Management, Inc. CGCW 1841 :3200 48' .1ve, Suite 11 , Vu'o Bexh, FL 32960 PROPOSAL TO : IRC PROJECT NAME : Utility Complex PROJECT ADDRESS: 4350 4154 St PROPOSAL DATE : Aug 2 2006 The scope of this proposal will include the following: Remove and replace 18 ea East Palatka. Holly trees and 9 ea Magnolia trees with larger than specified trees. This cost represents the difference between the originally specified trees and the cost for the new larger trees. Include labor to remove original trees. Summit Construction Management, Inc. will provide the above scope of work for a total proposed cost of: TOTAL PROPOSAL COST: 53,402.00 �`/ Pease - ign b � • rr�ny!--�"'"— tn1Z.� S "` 24 �� Yhone 0t; 1 ) 7N-200.9 Fav 15611 771.:LYW Zd L60Zb6LZLL Aisuun e7e 1n nn F V IRC Utility Complex Breakdown of Added Trees Originally Specified and Installed Trees Description Qty Tree Cost Installation Removal Cost Total Cost Magnolia 30 Gal 9 145.00 25.00 0 . 00 11530. 00 East Palatka Holy 30 Gal 18 110.00 25. 00 0 .00 2 .430. 00 Total Bid Cost 31960. 00 Larger Trees Required Description Qty Tree Cost Installation Removal Cost Total Cost Magnolia 65 Gal 9 245 . 00 25 . 00 50. 00 21880. 00 East Palatka Holly 45 Gal 18 174. 00 25 . 00 50 . 00 4 ,482 . 00 Total Bid Cost 71362 . 00 Net Difference in Cost 31402.00 £ 'd 160Z46) ZLL AlsuyC eZ£ LO 90 ZO 5ny CONTRACTOR'S APPLICATION FOR PAYMENT Application for Payment No. 17 - FINAL For Work Accomplished through the period of 6/20/2006 through 8/25/2006 To: Indian River County (Owner) From : Summit Construction Management (Contractor) Project No UCP #2229 Project: Indian River County Department of Utility Services - Operations Complex Owner's Bid No. : 7026 Engineer Brown & Caldwell Engineer's Contract No . : 1 . Original Contract Price: $ 5 , 148 , 921 . 00 2 Net change by Change Orders and Written Amendments ( + or -) : $ ( 379 , 922 . 23) 3 . Current Contract Price ( 1 plus 2 ) : $ 4. 768 , 998 . 77 4 . Total Work to date : 4a . Percentage of Work completed to date: 100 . 00% 4b . Total Work completed to date: $ 4 , 768 , 998 . 77 4c. Total equipment and material stored to date : $ 4d . Total Work completed and stored to date : (4b plus 4c) $ 4 , 768 , 998 . 77 5 . Retainage ( per Agreement) 5a . 0% of completed Work $ 5b 0% of stored equipment and material $ 5c . Total Retainage (5a plus 5b) $ 6 . Total Work completed and stored to date less retainage (4d minus 5c) $ 4 , 768 . 998 . 77 7 . Previous Applications for Payment $ 4 , 082 , 600 . 15 8 . AMOUNT DUE THIS APPLICATION (6 MINUS 7 ) $ 686,398.62 To: Indian River County (Owner) From : Summit Construction Management Inc. (Contractor) Project No . : UCP #2229 Project: Indian River County Department of Utility Services - Operations Complex Schedule Percent Amount Materials Total Previous Total Amount Item No. Item Description of Values Complete Completed Stored Completed & Completed & Amount % This Period This Period Stored Materials Stored to Date GENERAL CONDITIONS & ALLOWANCES : 1 Contractors Fee $221 , 111 . 00 100 . 00% $ 11 , 537 . 38 $209 , 573 .62 $221 , 111 . 00 2 Mobilization $20 , 800. 00 100 . 00% $0 . 00 $20 , 800. 00 $20 , 800 . 00 3 Bond & insurance $52 , 000. 00 100 . 00% $0 . 00 $ 52 , 000. 00 $52 , 000 . 00 4 Construction yard $ 10, 000. 00 100. 00% 1 $0 . 00 $ 10 , 000. 00 $ 10 , 000 . 00 5 Permit allowance $7 , 500. 00 100 , 00% 1 $ 1 , 396 . 71 $65103.29 $71500 . 00 6 Furniture allowance $90, 000. 00 100 . 00% 1 $0 . 00 $90 , 000. 00 $90, 000 . 00 7 Sicinaae allowance $ 15, 000. 00 100. 00% $0 . 00 $ 15 , 000. 00 $ 15, 000 . 00 8 Change Directive allowance: $385 . 52 100. 00% $385 . 52 $0. 00 $385. 52 #1 Fire Suppression system $3 , 818 . 00 100. 00% $0. 00 $3, 818 . 00 $32818. 00 #2 Getco Mezzanine $33 , 879. 10 100. 00% $0. 00 $33 , 879. 10 $33 , 879. 10 #3 Electronic o er. Door #6 $ 1 , 910. 00 100 . 00% $0 . 00 $ 1 , 910. 00 $ 1 , 910. 00 #4 Abandon flow wells $2, 964. 00 100 . 00% $0 . 00 $2 , 964. 00 $2, 964 . 00 #5 Admin . Bldg. flooring $7, 750. 00 100. 00% $0 . 00 $7 , 750. 00 $7, 750 . 00 Admin . Bldg. flooring ($7, 950 . 00) 100. 00% $0 . 00 -$7 , 950. 00 -$7, 950 . 00 #6 Admin . Bldg. add floor drain $325 . 66 100. 00% $0 . 00 $325 . 66 $325 . 66 #7 Admin . Bldg. add mason .walls $2 , 932 . 00 100. 00% $0 . 00 $2 , 932 . 00 $29932. 00 Admin . Bldg . accessory ch s. ($ 195. 00) 100. 00% $0 . 00 -$ 195 . 00 -$ 195. 00 Admin . Bldg . delete frame walls ($975. 00) 100. 00% $0. 00 -$975 . 00 -$975. 00 #8 Admin . Bldg . stucco changes $ 10,400. 00 100. 00% $0. 00 $ 10,400 . 00 $ 10 , 400. 00 #9 Admin . Bld . add TV/elect. outlt. $ 150. 00 100. 00% $0. 00 $ 150. 00 $ 150. 00 # 10 Add site conduit for Security $6 , 233. 55 100 . 00% 1 $0. 00 $8 , 233. 55 $8 , 233 . 55 # 11 Admin . Bldg . data conduit A$2 , 100. 00 100 . 00% $0 . 00 $ 3 ,439. 97 $3,439 . 97 # 12 Admin . Bld . increase AC slab 100 . 00 % $ 0 . 00 $2 , 100. 00 $2 , 100. 00 Admin . Bld . conduit for en . 100 . 00% $ 0 . 00 $908 . 28 $908. 28 Admin . Bld . relocate ref. lines 100 . 00% $0 . 00 $2 , 759 . 00 $2 , 759. 00 # 13 Add conduit to 41st Street 100 . 00% $ 0 . 00 $ 1 ,400 . 00 $ 1 ,400 . 00 # 14 Use interch . core ke s stem 100 . 00% $0 . 00 $ 1 , 080 . 00 $ 1 , 080 . 00 # 15 Admin . Bld . obscure lass 100 . 00% $0 . 00 $325 . 00 $325. 00 # 16 Admin . Bldg . electric outlet $365. 00 100 . 00% 1 $0 . 00 $365 . 00 $365. 00 # 17 Warehouse wood gate $309 . 23 100 . 00 % $0 , 001 $309 . 23 $309. 23 # 18 Admin . Bldg . change insulatn . $2 , 275 . 00 100 . 00% $0 . 00 $2 ,275 . 00 $2 , 275. 00 # 19 Add site light fixtures $7 , 778 . 27 100 . 00% $0 . 00 $7 , 778. 27 $7 , 778 . 27 #20 Deleted $0 . 00 0 . 00% $0 . 00 $0. 00 $0 . 00 #21 Site - add curb/sidewalk $ 1 , 967 . 00 100 . 00% $0. 00 $ 1 , 967. 00 $ 1 , 967 . 00 Schedule hPercent Amount Materials Total Previous Total Amount Item No. Item Description of Values Completed Stored Completed & Completed & Amount This Period This Period Stored Materials Stored to Date #22 Relocate louver, add hoods $650 . 00 $0 . 00 $650 . 00 $650 . 00 #23 Add site li ht fixture concrete $995 . 00 $0 . 00 $995 . 00 $995 . 00 #24 Electric chan es in Warehs . $ 1 , 669 . 00 $0 . 00 $ 1 ,669 . 00 $ 1 ,669. 00 #25 Delete irri ation at ROW -$4 , 500 . 00 $0. 00 -$4, 500 . 00 -$4, 500. 00 #26 Admin Bldg-add TV brackets $2 , 125 . 00 100. 00% 1 $0. 00 $2, 125. 00 $2 , 125. 00 #27 Warehouse - extra from Getco $2 ,691 .42 100. 00% 1 $0 . 00 $2,691 .42 $2 , 691 .42 #28 Warehouse - change paint $535 . 00 100 . 00% $ 0 . 00 $535. 00 $535. 00 #29 Add 2' to South dum ster wall $525 . 00 100. 00% $ 0 . 00 $525. 00 $525. 00 #30 Install irrigation mainline $ 1 , 575 . 00 100 . 00% $0 . 00 $ 1 , 575. 00 $ 1 , 575. 00 9 Fire detection allowance $ 15 , 000. 00 100 . 00% $0 . 00 $ 15 , 000. 00 $ 15 , 000. 00 9A Value Engineering Options $801 , 350. 00 100 . 00% $0 . 00 $801 , 350. 00 $801 , 350. 00 SITEWORK : 10 Sanitary sewer $50 , 960. 00 100 . 00% $0 . 00 $50 , 960. 00 $50, 960. 00 11 Clear/grub/mobilize $ 170 , 000. 00 100 . 00% $0 . 00 $ 170, 000. 00 $ 170, 000. 00 12 Earthwork $ 170 , 000. 00 100 . 00% $0 . 00 $ 170, 000. 00 $ 1702000 . 00 13 Silt fence $ 14 , 000. 00 100 . 00% $0 . 00 $ 14, 000 . 00 $ 14 , 000 . 00 14 Sub rade & base rock $ 180, 000. 00 100 . 00% $0 . 00 $ 180, 000 . 00 $ 180 , 000 . 00 15 Asphalt $ 135, 000. 00 100 . 00% $0 . 00 $ 135, 000 . 00 $ 135 , 000. 00 16 Drainage $95, 000. 00 100 . 00% $0 . 00 $95, 000 . 00 $95, 000. 00 17 Water service $ 16 , 000. 00 100 . 00% $0 . 00 $ 16, 000 . 00 $ 16 , 000. 00 18 Conduit $40 , 000. 00 100 . 00% 1 $0 . 00 $40, 000 . 00 $40, 000. 00 19 Curb & striping $ 18 , 000. 00 100 . 00% $0 . 00 $ 18, 000 . 00 $ 18, 000. 00 20 Landscaping & irrigation $ 180 , 000. 00 100 . 00% $0 . 00 $ 180, 000 . 00 $ 1802000. 00 21 Phase II landscaping $ 1 , 200. 00 100 . 00% $000 $ 1 ,200. 00 $ 1 ,200. 00 22 Fencing $80 , 000. 00 100 . 00% $0 . 00 $80, 000. 00 $809000 . 00 23 Pavers $2 , 500. 00 100 . 00% $0 . 00 $2 , 500. 00 $22500 . 00 24 Benches $25500 . 00 100 . 00% $0 . 00 $2 , 500. 00 $25500. 00 25 Flagpole $ 1 , 400. 001 100 . 00% $0 . 00 $ 1 ,400. 00 $ 1 ,400 . 00 26 Fountains $85000 . 00 100 . 000/0 $0 . 00 $8 , 000. 00 $8 , 000. 00 27 Concrete $455000 . 00 100 . 00% 1 $0 . 00 $45 , 000. 00 $451000. 00 28 Masonry $2 , 500 . 00 100 . 000/o $0 . 00 $2 , 500. 00 $2, 500. 00 29 Site electric $45 , 000 . 00 100 . 00% $0 . 00 $45 , 000. 00 $45 , 000. 00 Schedule Percent Amount Materials Total Previous Total Amount Item No. Item Description of Values Complete Completed Stored Completed & Completed & Amount % This Period This Period Stored Materials Stored to Date WAREHOUSE : 30 Concrete $2505000 . 00 100. 00% $0 . 00 $250 , 000 . 00 $250, 000 . 00 31 Mason $ 1555000 . 00 100. 00% $0 . 00 $ 155, 000 . 00 $ 155, 000 . 00 32 Metal building & structural $ 330 , 000 . 00 100. 00% $0 . 00 $330 , 000 . 00 $ 330 , 000 . 00 33 Cabinetry $8 , 000 . 00 100. 00% $0 . 00 $8, 000 . 00 $8, 000 . 00 34 Doors & hardware $ 13 , 000 . 00 100 . 00% $0 . 00 $ 13, 000 . 00 $ 13, 000 . 00 35 Overhead doors $ 16 , 000 . 00 100. 00% $0 . 00 $ 16, 000 . 00 $ 16, 000 . 00 36 Storefront $8 , 500 . 001 100. 00% $0 . 00 $8, 500 . 00 $8, 500 . 00 37 Paintin $22 , 000 . 00 100. 00% $0 . 00 $22 , 000 . 00 $22, 000 . 00 38 Framing/drywall/stucco $ 18 , 000 . 00 100 . 00% $0 . 00 $ 18, 000 . 00 $ 18, 000 . 00 39 Flooring $9 , 000. 00 100 . 00% $0 . 00 $9, 000 . 00 $9, 000 . 00 40 Bath accessories $5, 000. 00 100 . 00% $0 . 00 $5, 000 . 00 $5, 000 . 00 41 Shelving $ 1 , 800 . 00 100 . 00% $0 . 00 $ 1 , 800 . 00 $ 1 , 800 . 00 42 Plumbing $ 14 , 000 . 00 100 . 00% $0 . 00 $ 14, 000 . 00 $ 14, 000. 00 43 HVAC $60 , 000 . 00 100. 00% 1 $0 . 00 $60, 000. 00 $602000. 00 44 Electric $ 170 , 000 . 00 100. 00% $0. 00 $ 170 , 000. 00 $ 170 , 000. 00 ADMINISTRATION BUILDING : 45 Concrete $230, 000. 00 100. 00% $0 . 00 $2300000. 00 $2301000 . 00 46 Masonry $200, 000. 00 100 . 00% $0 . 00 $200, 000. 00 $200, 000 . 00 47 Metal building & structural $290, 000. 00 100 . 00% $0 . 00 $290, 000 . 00 $290, 000 . 00 48 Carpentry & lumber $20, 000. 00 100. 00% $ 0 . 00 $20, 000 . 00 $20, 000 . 00 49 Cabinetry $20, 000. 00 100 . 00% $0 . 00 $20, 000 . 00 $20, 000. 00 50 Doors & hardware $26, 000. 00 100 . 00% 1 $0 . 00 $26, 000. 00 $26, 000. 00 51 Storefront $55, 000. 00 100 . 00% 1 $0 . 00 $55, 000. 00 $55 , 000. 00 52 Accordian door $8 , 100. 00 100 . 00% $0 . 00 $8 , 100. 00 $8 , 100. 00 53 Painting $28 , 000 . 00 100 . 00% $0 . 00 $28 , 000. 00 $28 , 000. 00 54 Framinq & drywall & stucco $ 190, 000 . 00 100. 00% $0. 00 $ 190 , 000. 00 $ 190, 000 . 00 55 Flooring $ 300000 . 00 100 . 00% $0. 00 $ 30 , 000. 00 $ 30, 000 . 00 56 Epoxy flooring $ 8 , 500 . 00 100. 00% $0. 00 $80500 . 00 $82500. 00 57 Access flooring $4 , 000 . 00 100. 00% $0. 00 $4 , 000 . 00 $4, 000. 00 58 Bath accessories $ 85000 . 00 100. 00% $0. 00 $ 8 , 000 . 00 $8 , 000. 00 59 Partitions $ 75000 . 00 100 , 00% 1 $0. 00 $7, 000 . 00 $ 7 , 000. 00 60 Shelving $ 1 , 800 . 00 100. 00% $0. 00 $ 10800 . 00 $ 1 , 800. 00 61 Appliances $4 , 000 . 00 100 . 00% $0. 00 $4, 000 . 00 $4 , 000. 00 62 Markerboards $ 1 , 800 . 00 100 . 00% $0. 00 $ 1 , 800 . 00 $ 15800. 00 63 Plumbing $42 , 000 . 00 100 . 00% $0. 00 $42 , 000 . 00 $42 , 000. 00 64 HVAC $ 120 , 000 . 00 100 . 00% $ 0 . 00 $ 120, 000 . 00 $ 120 , 000 . 00 65 Electric $ 190 , 000 . 00 100 . 00% $ 0 . 00 $ 190, 000 . 00 $ 190 , 000 . 00 Schedule Percent Amount Materials Total Previous Total Amount Item No. Item Description of Values Complete Completed Stored Completed & Completed & Amount % This Period This Period Stored Materials Stored to Date CHANGE ORDERS : CO #1 Value En ineerin Options $ 801 , 350. 00) 100 . 00% $0 . 00 -$801 , 350. 00 -$8012350. 00 CO #2 Owner Purchased Material & Sanitary Sewer Changes -$434, 158 . 00 TOTAL: Owner purch . Ceco buildings ($367 , 000. 00) 100 . 00% $0 . 00 $367 , 000 . 00 ($367 , 000 . 00 Owner purch . Electrical items ($ 167 , 884 . 00) 100 . 00% $ 0 . 00 $ 167 , 884 . 00 $ 167 , 884 . 00) Revisions to Sanitary Sewer $ 100 , 726 . 00 100 . 00% 1 $0 . 00 $ 100, 726 . 00 $ 100, 726 . 00 CO #3 Owner Purchase furniture & Add Lift station & force main $602 , 082 . 00 TOTAL: Delete Owner purchased furniture ($90 , 000. 00) 100. 00% $0. 00 $90, 000. 00) $90 , 000. 00 Add Lift station & force main $692 , 082 . 00 100 . 00% $431082 . 00 $649 , 000 . 00 $692, 082 . 00 CO #4 Add generator $ 1995755. 00 100. 00% $ 174 , 755. 00 $25, 000. 00 $ 1995755. 00 CO #5 Added days $0. 00 100. 00% $0. 00 $0. 00 $0 . 00 CO #6 Add gutters&Site utilities changes $52 , 129. 00 100. 00% $0 . 00 $52 , 129 . 00 $ 52, 129. 00 CO #7 Allowance adjustment&Add trees $ 1 ,619. 77 100 . 00% $ 1 ,619 . 77 $ 1 ,619. 77 TOTAL $4,7685998.77 100 .00% $232, 776 .38 $0.00 $4,5361222 .39 $ 4,768 ,998.77 CONTRACTORS CERTIFICATION : UNDER PENALTY OF PERJURY, the undersigned CONTRACTOR certifies that ( 1 ) the labor and materials listed on this request for payment have been used in the construction of this Work and payment received from the last request for payment has been used to make payments to all subcontractors , laborers, materialmen , and suppliers except as listed below; (2) title of all Work, materials and equipment incorporated in said Work or otherwise listed in or covered by this Application for Payment will pass to OWNER at time of payment free and clear of all Liens , security interests and encumbrances (except such as are covered by a Bond acceptable to OWNER indemnifying OWNER against any such Lien , security interest or encumbrance) ; (3) all Work covered by this Application for Payment is in accordance with the Contract documents and not defective and (4) if this Periodic Estimate is for a Final Payment to project or improvement, I further certify that all persons doing work upon or furnishing materials or supplies for this project or improvement under this foregoing contract have been paid in full , and that all taxes imposed by Chapter 212 Florida Statutes , (Sales and Use Tax Act, as Amended ) have been paid and discharged , and that I have no claims against the OWNER . Dated Q ( 6 RZd Summit Construction Management Inc. (CONTRACTOR) By: Title : State of FloridaYPCHRIM SHUU" County Of Indian River My COMMISSION k DD 566610 �; .;•` EXPIRES'. October 21 , 201C Subscribed-and sworn tv o me before � Rf, BondedThNN Day of //77 ''k ce Notary Public Cg4�— My Commission ex Wes 10 - 2t - ZaC) NOTICE OF NON-PAYMENT. If one or more `Notice of Non-Payment' or "Notice to Owner" is received by the OWNER, no further payments will be approved until non- payments have been satisfied and a "Lien Waiver" for each "Notice" has been submitted to the OWNER. Upon request, CONTRACTOR shall furnish acceptable evidence that all such claims have been satisfied. The CONTRACTOR may, with consent of Surety and indemnification of the OWNER against any claims, receive payment for work for which there is an outstanding "Notice of Non-Payment' or "Notice to Owner " CERTIFICATION OF ARCHITECT OR CONSULTING ENGINEER (WHERE APPLICABLE ) : I certify that I have checked and verify the above and foregoing Periodic Estimate for Partial Payment; that to the best of my knowledge and belief it is a true and correct statement of the work performed and/or material supplied by the Contractor. Dated "�S - (ARCHITECT/ENGIN SIGNATURE) CERTIFICATION OF ENGINEER/INSPECTOR : I have checked the estimate against the Contractor's Schedule of Amounts for contract Payments and the notes and reports of my inspections of the project . It is my opinion that this statement of work performed and/or material supplied is accurate , that the Contractor is observing the requirements of the Contract, and that the Contractor should be paid the amount requested above . Dated I - �7 Q C • I (ARCHITEC /ENGINEER SIGNATURE) Accompanying Documentation : (The Remainder of Page Intentionally Left Blank) AAL Summit Construction Management, Inc. CGO058845 3200 43' Ave. Suite 11 , Vero Beach, FL 32960 ACCEPTANCE OF FINAL PAYMENT AS RELEASE The acceptance by the CONTRACTOR of final payment shall be and shall operate as a release to the OWNER from all claims and all liability to the CONTRACTOR other than claims in stated amounts as may be specifically excepted by the CONTRACTOR for all things done or famished in connection with this Work and for every act and neglect of the OWNER and others relating to or arising out of this Work. Any payment, however, final or otherwise, shall not release the CONTRACTOR or his sureties from any obligations under the Contract Documents or the Payment and Performance Bonds. PROJECT : INDIAN RIVER COUNTY DEPT. OF UTILITES — OPERATIONS COMPLEX, INDIAN RIVER COUNTY PROJECT #UCP2229 CONTRACTOR : Summit Construction Mgt. . Inc . William B . Schuh, President Date Signature State of Florida County of Indian River Subscribed and sworn before me this g day of September 2006 Seal y?N"'' '? CHRISTY SHULHAH (—�`' %C' V MYCOMMISSIONkDD 566619 Notary blic �' '' EXPIRES: '�Pf,h°"• eoaee m , �Y°ber 21, 201D No2ry Pum Untleiwnters My commission expires : C Hf;IS��/ 5♦i 1I uhf Ar LU — ZI — ZvIC� Phone (772) 794-2099 Fax (772) 794-2097