Common use of ENGINEER’S CERTIFICATION OF COMPLIANCE Clause in Contracts

ENGINEER’S CERTIFICATION OF COMPLIANCE. In accordance with the Terms and Conditions of the State-Funded Grant Agreement, the undersigned certifies that all work which originally required certification by a Professional Engineer has been completed in compliance with the Project construction plans and specifications. If any deviations have been made from the approved plans, a list of all deviations, along with an explanation that justifies the reason to accept each deviation, will be attached to this Certification. Also, with submittal of this certification the Recipient shall furnish the Department a set of “as-built” plans certified by the Engineer of Record/CEI. By: , P.E. SEAL: Name: Date: EXHIBIT D STATE FINANCIAL ASSISTANCE (FLORIDA SINGLE AUDIT ACT) THE STATE RESOURCES AWARDED PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: Awarding Agency: Florida Department of Transportation State Project Title and CSFA Number: County Incentive Grant Program (CIGP), (CSFA 55.008) Small County Outreach Program (SCOP), (CSFA 55.009) Small County Road Assistance Program (SCRAP), (CSFA 55.016) Transportation Regional Incentive Program (TRIP), (CSFA 55.026) Insert Program Name, Insert CSFA Number *Award Amount: $3,291,410.00 *The state award amount may change with supplemental agreements Specific project information for CSFA Number is provided at: xxxxx://xxxx.xxxxx.xxx/fsaa/searchCatalog.aspx

ENGINEER’S CERTIFICATION OF COMPLIANCE. In accordance with the Terms and Conditions of the State-Funded Grant Agreement, the undersigned certifies that all work which originally required certification by a Professional Engineer has been completed in compliance with the Project construction plans and specifications. If any deviations have been made from the approved plans, a list of all deviations, along with an explanation that justifies the reason to accept each deviation, will be attached to this Certification. Also, with submittal of this certification the Recipient shall furnish the Department a set of “as-built” plans certified by the Engineer of Record/CEI. By: , P.E. SEAL: Name: Date: EXHIBIT D STATE FINANCIAL ASSISTANCE (FLORIDA SINGLE AUDIT ACT) THE STATE RESOURCES AWARDED PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: Awarding Agency: Florida Department of Transportation State Project Title and CSFA Number: County Incentive Grant Program (CIGP), (CSFA 55.008) Small County Outreach Program (SCOP), (CSFA 55.009) Small County Road Assistance Program (SCRAP), (CSFA 55.016) Transportation Regional Incentive Program (TRIP), (CSFA 55.026) Insert Program NameLocal Programs Projects , Insert (CSFA Number 55.039) *Award Amount: $3,291,410.00 250,000.00 *The state award amount may change with supplemental agreements Specific project information for CSFA Number is provided at: xxxxx://xxxx.xxxxx.xxx/fsaa/searchCatalog.aspx

ENGINEER’S CERTIFICATION OF COMPLIANCE. In accordance with the Terms and Conditions of the State-Funded Grant Agreement, the undersigned certifies that all work which originally required certification by a Professional Engineer has been completed in compliance with the Project construction plans and specifications. If any deviations have been made from the approved plans, a list of all deviations, along with an explanation that justifies the reason to accept each deviation, will be attached to this Certification. Also, with submittal of this certification the Recipient shall furnish the Department a set of “as-built” plans certified by the Engineer of Record/CEI. By: , P.E. SEAL: Name: Date: EXHIBIT D STATE FINANCIAL ASSISTANCE (FLORIDA SINGLE AUDIT ACT) THE STATE RESOURCES AWARDED PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: Awarding Agency: Florida Department of Transportation State Project Title and CSFA Number: County Incentive Grant Program (CIGP), (CSFA 55.008) Small County Outreach Program (SCOP), (CSFA 55.009) Small County Road Assistance Program (SCRAP), (CSFA 55.016) Transportation Regional Incentive Program (TRIP), (CSFA 55.026) Insert Program NameLocal Transportation Projects, Insert CSFA Number 55.039 *Award Amount: $3,291,410.00 5,469,395.00 *The state award amount may change with supplemental agreements Specific project information for CSFA Number is provided at: xxxxx://xxxx.xxxxx.xxx/fsaa/searchCatalog.aspx

ENGINEER’S CERTIFICATION OF COMPLIANCE. In accordance with the Terms and Conditions of the State-Funded Grant Agreement, the undersigned certifies that all work which originally required certification by a Professional Engineer has been completed in compliance with the Project construction plans and specifications. If any deviations have been made from the approved plans, a list of all deviations, along with an explanation that justifies the reason to accept each deviation, will be attached to this Certification. Also, with submittal of this certification the Recipient shall furnish the Department a set of “as-built” plans certified by the Engineer of Record/CEI. By: , P.E. SEAL: Name: Date: EXHIBIT D STATE FINANCIAL ASSISTANCE (FLORIDA SINGLE AUDIT ACT) THE STATE RESOURCES AWARDED PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: Awarding Agency: Florida Department of Transportation State Project Title and CSFA Number: County Incentive Grant Program (CIGP), (CSFA 55.008) Small County Outreach Program (SCOP), (CSFA 55.009) Small County Road Assistance Program (SCRAP), (CSFA 55.016) Transportation Regional Incentive Program (TRIP), (CSFA 55.026) Insert Program Name, Insert CSFA Number *Award Amount: $3,291,410.00 1,750,000.00 *The state award amount may change with supplemental agreements Specific project information for CSFA Number is provided at: xxxxx://xxxx.xxxxx.xxx/fsaa/searchCatalog.aspx

ENGINEER’S CERTIFICATION OF COMPLIANCE. In accordance with the Terms and Conditions of the State-Funded Grant Agreement, the undersigned certifies that all work which originally required certification by a Professional Engineer has been completed in compliance with the Project construction plans and specifications. If any deviations have been made from the approved plans, a list of all deviations, along with an explanation that justifies the reason to accept each deviation, will be attached to this Certification. Also, with submittal of this certification the Recipient shall furnish the Department a set of “as-built” plans certified by the Engineer of Record/CEI. By: , P.E. SEAL: Name: Date: EXHIBIT D STATE FINANCIAL ASSISTANCE (FLORIDA SINGLE AUDIT ACT) THE STATE RESOURCES AWARDED PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: Awarding Agency: Florida Department of Transportation State Project Title and CSFA Number: County Incentive Grant Program (CIGP), (CSFA 55.008) Small County Outreach Program (SCOP), (CSFA 55.009) Small County Road Assistance Program (SCRAP), (CSFA 55.016) Transportation Regional Incentive Program (TRIP), (CSFA 55.026) Insert Program Name, Insert CSFA Number *Award Amount: $3,291,410.00 300,000.00 *The state award amount may change with supplemental agreements Specific project information for CSFA Number is provided at: xxxxx://xxxx.xxxxx.xxx/fsaa/searchCatalog.aspx