Form 700-010-05 "Unilateral Payment" - Florida

What Is Form 700-010-05?

This is a legal form that was released by the Florida Department of Transportation - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on August 1, 2018;
  • The latest edition provided by the Florida Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 700-010-05 by clicking the link below or browse more documents and templates provided by the Florida Department of Transportation.

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Download Form 700-010-05 "Unilateral Payment" - Florida

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700- 010-05
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
CONSTRUCTION
UNILATERAL PAYMENT
08/18
Page
of
(Pursuant to Section 337.11(12), Florida Statutes)
PROJECT DESCRIPTION:
No.
Fin. Proj. ID:
Federal Aid Project No.:
Road No.:
Contract No.:
County:
Date of Contract:
The above shall be referred to as the "Contract".
PAYMENT INFORMATION:
(1)
On or about the
day of
,
, the Florida Department of Transportation
"Contractor" is due additional sums of money
"Department" determined that
for work performed under the Contract and on the project described above, and the Department has elected to make
payment to the Contractor pursuant to Section 337.11(12), Florida Statutes as set forth and itemized below:
AMOUNT
DESCRIPTION OF EACH ITEM OF WORK
Revised Plan Sheet Nos.:
Granted Time (Due to delays to controlling items of work shown on approved work schedule):
days
Reason(s) for Granted Time:
(2) The quantities to be paid shall be necessary to complete the Contract. The quantities so determined shall be paid
at the unit prices stated above and on the attached sheet(s).
(3)
This unilateral payment does not alter or change in any manner the force and effect of the original Contract Documents,
including previous amendments thereto, except insofar as the same is altered and amended by this document.
(4) By acceptance of this unilateral payment the Contractor does not waive any rights the Contractor may have against
the Department for payment of any additional sums the Contractor claims are due for the described work.
(5) All sums paid by the Department hereunder shall be credited against the sums that may be due the Contractor for
the itemized work described above in the amounts set forth above. The Contractor shall apply the payment made
hereunder to the items described above and in the amount shown above.
Approved By:
Amount of this Payment $
Secretary or Designee Signature
Date of Funds Approval:
Copies:
Executed By:
Surety
Contractor
Secretary or Designee Signature
Attorney Signature, Department of Transportation, Legal Review
700- 010-05
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
CONSTRUCTION
UNILATERAL PAYMENT
08/18
Page
of
(Pursuant to Section 337.11(12), Florida Statutes)
PROJECT DESCRIPTION:
No.
Fin. Proj. ID:
Federal Aid Project No.:
Road No.:
Contract No.:
County:
Date of Contract:
The above shall be referred to as the "Contract".
PAYMENT INFORMATION:
(1)
On or about the
day of
,
, the Florida Department of Transportation
"Contractor" is due additional sums of money
"Department" determined that
for work performed under the Contract and on the project described above, and the Department has elected to make
payment to the Contractor pursuant to Section 337.11(12), Florida Statutes as set forth and itemized below:
AMOUNT
DESCRIPTION OF EACH ITEM OF WORK
Revised Plan Sheet Nos.:
Granted Time (Due to delays to controlling items of work shown on approved work schedule):
days
Reason(s) for Granted Time:
(2) The quantities to be paid shall be necessary to complete the Contract. The quantities so determined shall be paid
at the unit prices stated above and on the attached sheet(s).
(3)
This unilateral payment does not alter or change in any manner the force and effect of the original Contract Documents,
including previous amendments thereto, except insofar as the same is altered and amended by this document.
(4) By acceptance of this unilateral payment the Contractor does not waive any rights the Contractor may have against
the Department for payment of any additional sums the Contractor claims are due for the described work.
(5) All sums paid by the Department hereunder shall be credited against the sums that may be due the Contractor for
the itemized work described above in the amounts set forth above. The Contractor shall apply the payment made
hereunder to the items described above and in the amount shown above.
Approved By:
Amount of this Payment $
Secretary or Designee Signature
Date of Funds Approval:
Copies:
Executed By:
Surety
Contractor
Secretary or Designee Signature
Attorney Signature, Department of Transportation, Legal Review
700-010-05
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
CONSTRUCTION
UNILATERAL PAYMENT
08/18
(Pursuant to Section 337.11(12), Florida Statutes)
Page
of
Fin. Proj. ID:
Federal Aid Project No.:
Road No.:
Contract No.:
Date of Contract:
County:
DESCRIPTION OF EACH ITEM OF WORK
AMOUNT
Page of 2