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SURETY'S CONSENT OF PAYMENT TO CONTRACTOR: <br />The Surety, <br />Page 3 of 6 <br />corporation, in accordance with Public Construction Bond Number <br />consents to payment by the OWNER to the CONTRACTOR, for the amounts sp <br />this CONTRACTOR's APPLICATION FOR PAYMENT. <br />TO BE EXECUTED BY CORPORATE SURETY: <br />Attest: <br />,a <br />, hereby <br />cified in <br />Secretary Corporate Surety <br />STATE OF FLORIDA <br />COUNTY OF INDIAN RIVER <br />Business Address <br />BY: <br />Print Name: <br />Title: <br />(Affix Corporate SEAL) <br />Before me, a Notary Public, duly commissioned, qualified, and acting, personall <br />, to me well known or wh <br />as identification, who being by me first <br />upon oath, says that he/she is the <br />and that he/she has been authorized by it to approv <br />by the OWNER to the CONTRACTOR of the foregoing Contractor's Appl <br />Payment. Subscribed and sworn to before me this <br />, 20 <br />appeared <br />produced <br />my sworn <br />for <br />payment <br />cation for <br />day of <br />Notary Public, State of <br />My Commission Expires: <br />**************************************************************************************************** <br />[The remainder of this page was left blank intentionally] <br />00622 - Contractor's Application for Payment- 03-10 rev.doc <br />00622 - 3 <br />F:\Public Works\ENGINEERING DIVISION PROJECTS \1314 -107th Ave Milling_90th St to 94th St\Admin\bid documents\Master Contract Documents\00622 - Con <br />for Payment - 03-10 rev.doc Rev. 05/01 <br />ctor's Application <br />