R/W ITEM/SEGMENT NO.:	MANAGING DISTRICT:
CONSTRUCTION ITEM/SEGMENT NO.:	STATE ROAD:
F.A.P. NO. (Construction):	DESCRIPTION:
COUNTY:
LETTING DATE:

The undersigned hereby certifies as follows:

Title to all property and easements needed for the above construction project is vested in the Florida Department of Transportation (Department) or a state or local government. The Department or a state or local government has obtained sufficient authority to construct and maintain the proposed improvements on property and easements owned by state or local governments. Further:

Acquisition

Right of way was not acquired for this project.

Right of way was acquired for this project in compliance with applicable state and federal law.

Relocation

No persons or businesses were required to move or move personal property from the project right of way.

All persons and businesses that were required to move or move personal property from the project right of way have been provided relocation assistance in compliance with applicable state and federal law.

Demolition

No structures or improvements, including encroachments, required removal from the project right of way.

All structures and/or improvements, including encroachments, have been removed from the project right of way in compliance with applicable state and federal law, or will be included in the construction contract.

Asbestos Abatement

No structures or improvements requiring asbestos abatement were located on the project right of way.

Asbestos abatement of buildings and/or structures, including those to be removed by the construction contractor, has been completed in compliance with applicable state and federal law, or will be included in the construction contract.

Certified by Local Agency:

Title: someone with authority to sign (Add Title)	Date:

Acknowledged by:

Title: Carlos Martinez, District Right of Way Manager	Date: