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Application for Payment No. 3 Final <br />SURETY'S CONSENT OF PAYMENT TO CONTRACTOR: <br />The Surety, Travelers Casualty and Surety Company of America <br />,a <br />corporation, in accordance with Public Construction Bond Number 106051547 hereby <br />consents to payment by the OWNER to the CONTRACTOR, for the amounts specified in <br />this CONTRACTOR'S APPLICATION FOR PAYMENT. <br />TO BE EXECUTED BY CORPORATE SURETY: <br />Attest- <br />./, <br />Witnesj <br />BY: <br />STATE OF FLORIDA <br />COUNTY OF INDIAN RIVER <br />Travelers Casualty and Surety Company of America <br />Corporate Surety <br />reg PB <br />Print N <br />Title: <br />helps <br />orney-li Fact and FL Resident Agent <br />(Affix Corporate SEAL) <br />Before me, a Notary Public, duly commissioned, qualified, and acting, personally appeared <br />William Phelps , to me well known or who produced <br />Personally Known as identification, who being by me first duly sworn <br />upon oath, says that the is the Attorney -In -Fact for <br />and that he/she has been authorized by Tr•" .e..u..Ms'.yocmp.n"M'edeit to approve payment by the <br />OWNER to the CONTRACTOR of the foregoing Contractor's Application for Payment. <br />Subscribed and sworn to before me this lob day of A�&y..�C� , 20% <br />otary ' blic, State of n Rt d <br />My ission Expires: .1-1//.?1/0 <br />************,tint***s* ***** r**arae*******************irk* ft* ********* tttk*,tx************ ****** ***OWti:;; ,,d <br />[The remainder of this page was left blank intentionally] <br />162 <br />