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SCANNED
BY
St. Lucie County
G732 CMa (formerly G702 CMa) APPLICATION and CERTIFICATE for PAYMENT
To: Islaqnd Crest Condominium
Project: Island Crest Concrete restoration Application No: 3
Distribution to:
10680 South Ocean Blvd.
App. Date: January16, 2019
® OWNER
Jensen Beach, FL31957
❑ CONSTRUCTION MGR.
Period to:
❑ ARCHITECT
From: Blue Mast Construction
® CONTRACTOR
2587 SE Monroe at
Project No:
❑ OTHER
Stuart, Florida 34997
Contract Date:
Contract For: Concrete Restoration Construction Manager. Florida Consulting Engineers Architect:
APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge,
Application is made for payment, as shown below, in connection with the Contract. information and belief the Work covered by this Applicetlon for Payment has been completed
in accordance with the Contract Documents, that all amounts have been paid by the
Continuation Sheet G703, Is attached. Contractor for work for which previous Certificates for Payment were Issued and payments
1. ORIGINAL CONTRACT SUM 169,376.66 received from the Owner, and Nat current payment shown herein is now due.
2. Net Change By Change Orders O.DD CONTRACTOR:
3. CONTRACT SUM TO DATE 169,376.66 By: Date:
4. TOTAL COMPLETED AND STORED TO DATE 142,046.91
5. RETAINAGE:
State of:
County of:
a. of Completed Work
0.00
Subscribed and swom before me this day of
b. of Stored Materiel
0.00
The above personally appeared before me, the undersigned notary public, and provided
satisfactory evidence of Identification to be the person who signed this document in my
TOTAL RETAINAGE
0.00
Presence and swore or aRrmed tome That the contents of this document are truthful and
6. TOTAL EARNED LESS RETAINAGE
142,048.91
accurate to the best of his/her knowledge and belief.
7. LESS PREVIOUS CERTIFICATES FOR
PAYMENT 129,452.83
Notary Public: My Commission expires:
CERTIFICATE FOR PAYMENT
B. CURRENT PAYMENT DUE
12,596.08
In accordance with the Contract Documents, based an on -site observations and the data
9. BALANCE TO FINISH, INCLUDING RETAINAGE 27,327.75
comprising this application, the Construction Manager and Architect certify to the Owner that
to the best of their knowledge. Information and belief the Work has progressed as Indicated,
the quality of the Work is in accordance with the Contract Documents, and the Contractor is
united to payment of the AMOUNT CERTIFIED.
CHANGE ORDER SUMMARY
ADDITIONS
DEDUCTIONS
Total changes approved in
previous months by Owner
0.00
0.00
Total approval this Month
0.00
0.00
TOTALS
0.00
0.00
NET CHANGES by Change Order
0.00
AMOUNT CERTIFIED
CONSTRUCTION MANAGER:
By:
ARCHITECT:
By:
Date:
Date:
This Certiliwte is not negotiable. TheAMOUNT CERTIFIED is payable only to the
Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.
CAUTION: You should use an original document which has this caution printed in red. An original assures that changes will not be obscured as may occurwhen Documents are reproduced.
CAUTION: You should use an odainal document which has this caution printed in red. An original assures that chanties will not be obscured as may occurwhen documents are reoroduced.
G732 CMa (formerly G702 CMa) APPLICATION and CERTIFICATE for PAYMENT
To: Islaqnd Crest Condominium Project: Island Crest Concrete restoration Application No: 2 Distribution to:
10680 South Ocean Blvd.
Jensen Beach, FL 31957 App. Date: January 16, 2019 LJ OWNER
❑ CONSTRUCTION MGR.
From: Blue most Construction Period to: ❑ ARCHITECT
2587 SE Monroe st _ Project No: ® CONTRACTOR
❑ OTHER
Stuart, Florida 34997 Contract Date: '
Contract For. Concrete Restoration Construction Manager: Florida Consulting Engineers Architect:
APPLICATION FOR PAYMENT
Application is made for payment, as shown below, in connection with the Contract
Continuation Sheet, G703, Is attached.
1. ORIGINAL CONTRACT SUM
169,376.66
2. Net Change By Change Orders
D.Do
3. CONTRACT SUM TO DATE
169,376.66
4. TOTAL COMPLETED AND STORED TO DATE
142,048.97
5. RETAINAGE
The undersigned Contactor certifies that to the best of the Contractors knowedge,
Information and belief the Work covered by this Application for Payment has been completed
In accordance with the Contact Comments, that all amounts have been paid by the
Contractor for Work for which previous Certificates for Payment were Issued and payments
received from the Owner, and that anent payment shown herein Is now due.
CONTRACTOR:
By:
State of:
Date:
County of:
a, of Completed Work
12,596.08
Subscribed and swom before me this day of
b. of Stored Material
g.00
The above personally appeared before me, the undersigned notary public, and provided
satisfacbry evidence of Identification to be the person who signed this dowment in my
TOTAL RETAINAGE
12,59fi.06
Presence and swore of afinned to me that the contents of this document are truthful and
6, TOTAL EARNED LESS RETAINAGE
129,452.83
eccurme to the best of hismer knowledge and belief.
7. LESS PREVIOUS CERTIFICATES FOR
PAYMENT 103,538.53
Notary Public: My Commission expires:
B. CURRENT PAYMENT DUE
25,914.30
CERTIFICATE FOR PAYMENT
In accordance with the Contract Documents, based on on -site observations and the data
9. BALANCE TO FINISH, INCLUDING RETAINAGE
39,923.83
comprising this application, tha Consmction Manager and Architect certify to the Owner that
to the best of their knowledge, information and belief the Work has progressed as Indicated,
the quality of the Work is in accordance with the Contract Documents, and the Contractor is
armed to payment of the AMOUNT CERTIFIED.
CHANGE ORDER SUMMARY
ADDITIONS
DEDUCTIONS
Total changes approved in
previous months by Owner
Total approval this Month
0.00
0.00
TOTALS
0.00
0.00
NET CHANGES by Change Order
0.00
AMOUNT CERTIFIED
CONSTRUCTION MANAGER
By: Date:
ARCHITECT.
By: Date:
This Certificate Is not negotiable. The AMOUNT CERTIFIED Is payable only to the
Contractor named herein. Issuanco, payment and acceptance of payment ere without
prejudice to any rights of the Owner or Contactor under this Conlract
CAUTION: You should use an original document which has this caubon printed in red. An original assures that changes coif not be obscured as may occur when documents are reproduced.
CAUTION: You should use an oriamal document which has this caution printed in red. An ofioinal assures that chances will not be obscured as may occur when documents are reproduced.
G732 CMa
ON and CERTIFICATE for PAYMENT
To:
From:
Islaqnd Crest Condominium
10680 South Ocean Blvd.
Jensen Beach, FL 31957
Period to:
!/C�/✓l (� Project No:
ontract Date:
2587 SE Monroe st
Stuart, Florida 34997
Contract For: Concrete Restoration
Construction Manager: Florida Consulting Engineers
APPLICATION FOR PAYMENT
". iplication is made for payment, as shown below, in connection with the Contract.
intinuation Sheet, G703, is attached.
1. ORIGINAL CONTRACT SUM
169.376.66
2. Net Change By Change Orders
0.00
3. CONTRACT SUM TO DATE
169,376.66
4. TOTAL COMPLETED AND STORED TO DATE
142,048.91
5. RETAINAGE
a. of Completed Work
b. of Stored Material
TOTAL RETAINAGE
6. TOTAL EARNED LESS RETAINAGE
12,596.08
0.00
12,596.08
129,452.83
7. LESS PREVIOUS CERTIFICATES FOR PAYMENT 103,538.53
°. CURRENT PAYMENT DUE 25,914.30
BALANCE TO FINISH, INCLUDING RETAINAGE 39,923.83
CHANGE ORDER SUMMARY
ADDITIONS
DEDUCTIONS
Total changes approved in
previous months by Owner
Total approval this Month
0.00
0.00
TOTALS
0.00
0.00
NET CHANGES by Change Order
0.00
Project: Island Crest Concrete restoration Application No: 2
App. Date: January 16, 2019
Architect:
Distribution to:
® OWNER
❑ CONSTRUCTION MGR.
❑ ARCHITECT
® CONTRACTOR
❑ OTHER
The undersigned Contractor certifies that to the best of the Contractor's knowledge,
information and belief the Work covered by this Application for Payment has been completed
in accordance with the Contract Documents, that all amounts have been paid by the
Contractor for Work for which previous Certificates for Payment were issued and payments
received from the Owner, and that current payment shown herein is now due.
CONTRACTOR:
0
State of:
Date:
County of:
Subscribed and swom before me this day of
The above personally appeared before me, the undersigned notary public, and provided
satisfactory evidence of identification to be the person who signed this document in my
presence and swore or affirmed to me that the contents of this document are truthful and
accurate to the best of his/her knowledge and belief.
Notary Public:
CERTIFICATE FOR PAYMENT
My Commission expires:
In accordance with the Contract Documents, based on on -site observations and the data
comprising this application, the Construction Manager and Architect certify to the Owner that
to the best of their knowledge, information and belief the Work has progressed as indicated,
the quality of the Work is in accordance with the Contract Documents, and the Contractor is
entitled to payment of the AMOUNT CERTIFIED.
1 ilrj NAi!11163:1'.�i11IsLx:
CONSTRUCTION MANAGER:
By: Date:
ARCHITECT:
By: Date:
This Certificate Is not negotiable. The AMOUNT CERTIFIED is payable only to the
Contractor named herein. Issuance, payment and acceptance of payment are without
prejudice to any rights of the Owner or Contractor under this Contract.
CAUTION: You should use an original document which has this caution printed in red. An original assures that changes will not be obscured as may occur when documents are reproduced.
CAI ITIOW Ynu shnuld use an nrininal dnrnme.nt which hae this raution nrintad in rod An nrininal aacurec that rhannas will not he ohanirad ac may orcur when documents am renrnduced