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/�J rtc <br />1 L, <br />Credit Application <br />9. If not paid within 45 days, credit will be discontinued. <br />10. If not paid within 60 days, Surety Bond shall be utilized to �.. <br />,y)LL satisfy the payment of the amount due including interest orfTl <br />any cost associated with collection. <br />L , <br />11. Applicant agrees to Post Cash Bond in the amount determined <br />?.+b-i ti' j A : by the County. : <br />�Fluypk'` ? YES or NO r' 1 <br />111®� <br />12. Applicant agrees to provide the County with a Surety Bond in <br />the proper form in the amount determined by the county. } <br />Al <br />YES or NO e / <br />13. Bonding or Insurance Company: Name e ` <br />3,t i.rry <br />? Address: <br />COMPLETE APPROPRIATE SIGNATURE BLOCKS <br />j Principal Principal (SEAL) <br />.1 <br />rl Signature (1) by (SEAL) <br />Co-partner or gen. partner Pres. or Vice Pres. I <br />, <br />Signature (2) by <br />Co-partner or gen. partner Secretary or Asst. Sec. <br />� 7 <br />r FIRM OR INDIVIDUAL <br />Witness (1) Principal <br />rI <br />Witness (1) Signature <br />(Individual or Owner) 'if <br />I Witness (2) <br />I Witness (2) Witness <br />i <br />t4 1 <br />Date Witness <br />rr;� <br />County Official Use Only <br />1. Bond received in the amount of I <br />2. Bond received in proper form: YES NO I, <br />3. Term of Bond <br />4. Date processed by Indian River County <br />rl "' S. SWDD vehicle numbers <br />td <br />1 <br />I <br />creditap/sms rl <br />-21- { <br />�.: tI r <br />e'ir.; 1, <br />� <br />J .., <br />f 1 <br />.. ,5 <br />JrP <br />I <br />