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Payment No. 3 p B Post, Buckle~ Schuh & Jernigan, Inc. s J CONSULTING ENGINEERS and PLANNERS 10 PALMS PLAZA, HOMESTEAD, FLORIDA 33030-6094 . 305/248-4750 . TELEX 808435 June 4, 1982 Mr. Edward L. Stickney, Director Monroe County Public Works Department Public Services Building Wing II - Stock Island Key West, Florida 33040 Dear Mr. Stickney: We have reviewed the enclosed application for payment #3 from The Brewer Co. of Fla. Inc. for improvements to Old 4A Little Torch Key, and find it to be correct as to work completed, and recommend payment in the amount of $92,064.16. We have negotiated an agreement with the contractor for his extra work in roadway excavation, and fill material, in the amount of $32,386.96, this amount is included in payment #3. To bring the contract up to date and to pay the contractor for his extra work, we are enclosing change order #1 for your signature. Very truly yours, ~~~ H. Le Swanson, P .E. HLS/sm 401-002.11 1"..;;, "F' (? \7.) '"")'1 Q\-:::}]...""'.... i It')' " ,i, H' ., t " , I L ';,1 ~ ~.I .J IJ N 7 1982 COUNTY hTlY. I / CONTRACTOR: Page 1 of 3 APrLICATION FOR I'AYiIlEN'I' NO. 3. The Brewer Company of Florida, Inc. - PROJECT NUMBER: PROJECT NAr~: Paving, Grading, & Drainage Improvements, Old 4A Road OWNER: F'ERIOD ENDING I Monroe County, FloridJ. DATEl 1 June 1982 AMOU EARNED TO DATE r ~ r- Unit Amount Amount cent 870 C.Y. 10.0 8700'.0 870 8700. 100% Item Description No. of Ite:n 1. Roadway Excavation la. Roadway Excavation Overrun 2. Fill Mat'1. 2a. Fill Mat'l. Overrun 3. 6" Limerock Base '4. 1 1/2" Type S-l Asphalt 5. Concrete (Class B) 1994 C.Y. 10005 9,149.55 100% 1994 9,940.00 100% 10005 C.Y. 9.91 9149.5 1256 C.Y. 9. 9 12446.96. 1256 2,446.96 100% 22500 S.Y. 20520 1 3,900.00 100% 3.50 8750.0 22500 8,750.00 100% 20520 S.Y. 23 C.Y. 200.00 4600. 23 4,600.00 100% * To be adj sted by a ount reuseable to be det rmine APPROVED O~J BOOK 1- f exca ated m teria1 th t is by th Engin ere _L -- - - ...- - ~-_. -----. _._-- - _ ____ _~_7!_4J3.f?._51 377 ,486.51 AtLtchm(!nt :JJ. 1 l'+ige 1 ) 1 APPLICATION FOR PAYMENT NO.3 Project No. . Project Name: _!>~.YingLg!"_ading, & Drainage Improvements, Old 4A Road Owner: MQn~oe County. Florida Contractor: _~_he__~-.!"ewer~ompany of F lor ida, Inc. 1. Value of original contract work performed to date: 2. Extra work performed to date: 3. Materials dccepted ,md stored at site: 4. Gross value to date: 5. Ten percent retained: 6. Net amount due to date: 7. Less; previous net amount: 8. Balance due for this payment: Note: This Application must be accompanied with the Certification of Con- tractor Form. IG-24 401-002.1t CERTIFICATION 01-' CONTRACTOR According to the best of my knowledge and belief, I certify that all items and amounts shown on Application for Payment No. ~ are correct, that all work has been performed and/or materials supplied in full accordance with the terms and conditions of this Contract, dated 9-22- ,1981, between _____.M..Oilroe COJJ.I1_tYL._Florida (Owner) > and The Brewe~_Co~p-~~yof Florida, Inc. (Cont ractor) I further certify that all just and lawful bills against the undersigned and his subcontractors :In.t suppliers for labor, material and equipment em- ployed in the performance of this Contract have been paid in full accordance with their terms lfld conditions; that all taxes imposed by Chapter 212, Flor- ida Statutes (Sa l.~s and Use Tax Act), as amended, have been paid and dis- charged; and that Lhere dre no Vendor's, Mechanic's or' other Liens or rights to liens or cund'ti"oal :;ales contracts which should be satisfied or dis- charged before :,!, 'I f"1ynlt'nt is made. The Brewer Company )otl?lorida, Inc. Date: _2June 1982 Contractor: c;i:~0- W.R.Brewer, Ass1t. Vice-President STATE OF Florida COUNTY OF Dade ) Personally l.,),.,rt'd twfore me this 2nd day of June , 19 82, _____~alt.!3r R. Brewer_____ known (or made known) to me to be the ---( Own~r) Ass istant _y.:J:g~-Pr~_~J_~~nt (Partner) (Corporate Officer - Give Title) of ____1'.he_,8%ewer Compan.:~~_9_f_F lo!:'Ma-'-.:rnc ~____ Contractods) , who subscribe:i .Ll! :;~,)_ (- ~ll the above instrument in my presence. ~~~QW~ Na~..c.....-.R.Qherts c.::Jtary Publ ic - (Type N::llTl~) : . My Commission Expires: Notary Public State Df Aorida at Large. My CDmmissiDn Expires April 22. 1983. 19 Tile Contractor shall execute this Certificate dnd attach it to each Ap- plication For Payment. IG-25 401-002.1t