Form 700-011-04 "Certification Work Done by Contractor or Subcontractor Under the Florida Minority Business Loan Mobilization Program" - Florida

What Is Form 700-011-04?

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 February 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;

Download a fillable version of Form 700-011-04 by clicking the link below or browse more documents and templates provided by the Florida Department of Transportation.

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Download Form 700-011-04 "Certification Work Done by Contractor or Subcontractor Under the Florida Minority Business Loan Mobilization Program" - Florida

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STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
700-011-04
CONSTRUCTION
CERTIFICATION
02/18
WORK DONE BY CONTRACTOR OR SUBCONTRACTOR UNDER
THE FLORIDA MINORITY BUSINESS LOAN MOBILIZATION PROGRAM
DATE:
FIN PROJ. I.D.:
CONTRACT NO.:
FOR MONTH OF:
, PARTICIPANT IN THE FLORIDA
MINORITY BUSINESS LOAN MOBILIZATION PROGRAM, HEREBY CERTIFIES THAT THE FOLLOWING
REPRESENTS THE TRUE VALUE OF WORK DONE FOR THE CURRENT PAYMENT PERIOD.
PAY ITEM
QUANTITY
UNIT OF MEASURE
UNIT PRICE
AMOUNT
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
emarks:
R
THIS AMOUNT WILL BE DEDUCTED FROM THE MONIES
ADVANCED TO YOU UNDER THIS PROGRAM IN ACCORDANCE
WITH SEC. 7-1.9 OF THE SPECIFICATIONS.
$ 0.00
TOTAL
PROGRAM PARTICIPANT
PRIME CONTRACTOR (IF SUBCONTRACTOR IS PARTICIPANT)
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
700-011-04
CONSTRUCTION
CERTIFICATION
02/18
WORK DONE BY CONTRACTOR OR SUBCONTRACTOR UNDER
THE FLORIDA MINORITY BUSINESS LOAN MOBILIZATION PROGRAM
DATE:
FIN PROJ. I.D.:
CONTRACT NO.:
FOR MONTH OF:
, PARTICIPANT IN THE FLORIDA
MINORITY BUSINESS LOAN MOBILIZATION PROGRAM, HEREBY CERTIFIES THAT THE FOLLOWING
REPRESENTS THE TRUE VALUE OF WORK DONE FOR THE CURRENT PAYMENT PERIOD.
PAY ITEM
QUANTITY
UNIT OF MEASURE
UNIT PRICE
AMOUNT
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
$ 0.00
emarks:
R
THIS AMOUNT WILL BE DEDUCTED FROM THE MONIES
ADVANCED TO YOU UNDER THIS PROGRAM IN ACCORDANCE
WITH SEC. 7-1.9 OF THE SPECIFICATIONS.
$ 0.00
TOTAL
PROGRAM PARTICIPANT
PRIME CONTRACTOR (IF SUBCONTRACTOR IS PARTICIPANT)