CN-550000-C9385-00020000.pdf

Contract No.

Financial Project I.D.

F.E.I.D. No.

THIS CERTIFICATION OF COMPLETION AGREEMENT, made and entered into this day of , , by and between the STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION, an agency of the State of Florida, hereinafter called the "Department," and of duly authorized to conduct business in the State of Florida, hereinafter called the "Consultant."

WITNESSETH:

WHEREAS, the Department and the Consultant heretofore on , entered into an Agreement whereby the Department retained the Consultant to furnish certain services in connection with

; and

WHEREAS, the services which the Consultant agreed to furnish are 100% complete, for which the Consultant is detailed as follows:entitled to a fee of $ and;

WHEREAS, there has been previously paid to the Consultant under the terms of said Agreement the sum of still due and payable to the Consultant by the Department;Leaving a balance of $ due and payable to the Department by the Consultant;Leaving an overpayment of $

NOW, THEREFORE, THIS INDENTURE WITNESSETH: That the Consultant , does hereby agree with the Department to the completion of the Agreement dated , and all amendments and supplemental agreements thereto, except for those provisions wherein the Consultant agrees to protect, indemnify, defend, save, and hold harmless the Department from all claims, demands or liabilities which may arise out of or because of said Agreement, which provisions will remain in full force and effect. The Consultant agrees that the amount to be paid is the final payment due for services rendered pursuant to the Agreement.

STATE OF FLORIDA

DEPARTMENT OF TRANSPORTATION

Name of Consultant

BY: BY:

Authorized Signature

(Print/Type) (Print/Type)

Title: Title:

Contracting Office Approval:

(This date to be entered by DOT only)

STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION

PROCUREMENT

375-030-81

OGC - 07/15CERTIFICATION OF COMPLETION AGREEMENT

IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed, the day and year first above written.

C-9385

42884513201

592606484

Eisman & Russo, Inc.

6455 Powers Avenue, Jacksonville, FL 32217-2821

Design of State Road 187 (US 331) from State Road 10 (US 90) to Alabama State Line in Walton County

1,549,411.66

42884513201 - $1,548,461.20 42884516203 - $950.46

1,549,411.66

0.00

Eisman & Russo, Inc.

Jared Perdue, P. E.

Director of Transportation Development

Procurement Services Manager ïðñïîñïï ïðñïîñïï

DocuSign Envelope ID: 333DD7E9-9E3D-4419-974C-454FC42BA921

CFO/EVP

Michael Greene

October21st