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2. Updated Construction Schedule per Specification Sect on 01310, and <br />Dated September 4, 2015 <br />STATE OF FLORIDA <br />COUNTY OF ST LUCIE <br />By: <br />(CO TRA TOR — must be signed by <br />an Officer the Corporation) <br />Page 2 of 5 <br />Lang T Dale, President <br />Print Name and Title <br />Before me, a Notary Public, duly commissioned, qualified, and acting, personally appeared <br />Larry T Dale , who being by me first duly swom upon oath, says that he/she is the <br />_President of the CONTRACTOR mentioned above and that he/she has been duly <br />-authorized to- act- on -behalf-of it,--and-that he/sheexecutedthe. above_Contractor's Application. for <br />Payment and Contractor's Certification statement on behalf of said CONTRACTOR; and that all of <br />the statements contained herein are true, correct, and complete. Subscribed and swom to before <br />me this 4th day of September , 20 15 . <br />Larry T Dale is personally known to me or has produced <br />as identification. <br />NOTARY PUBLIC: <br />(SEAL) Printed name: <br />SELENA C. DEWEY <br />NOTARY PUBLIC <br />STATE OF FLORIDA <br />oemm# EE163327 <br />Expires 4/8/2016 <br />Commission No.: <br />Commission Expiration: <br />*****************************************************************A J, ********************************* <br />[The remainder of this page was left blank intentionally] <br />Retainage Pay Request #29 <br />00622 - 2 <br />Z\My DocumentstExcellspedal est forms43949 - 66thtRetainage Pay Request #29.doc Rev. 05/01 <br />113 <br />