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2. Updated Construction Schedule per Specification Section 01310 <br /> Dated By: <br /> (CONTRACTOR— must be-signed by- <br /> an Officer of the Corporation) <br /> Print Name and Title <br /> STATE OF FLORIDA, <br /> COUNTY OF INDIAN RIVER <br /> Before me, a Notary' Public; duly -commissioned, qualified, and acting, personally -appeared <br /> who being by' me first-- duly sworn_ upon oath, .says that he/she, is the <br /> of the CONTRACTOR-mentioned above and-that he/she--has been duly <br /> _authorized to act on behalf of it, and that he/she executed-the 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; arid. complete._ Subscribed and sworn to.before <br /> me this day of ; 20 <br /> is personally known to me or has produced <br /> as identification. <br /> NOTARY PUBLIC: <br /> (SEAL) Printed nariite: <br /> Commission No:: <br /> Commission Expiration: <br /> Please;remit payment to: <br /> Contractor's.Name: <br /> Address: <br /> [The remainder of this pagewas left blank intentionally] <br /> 00622-Contractors AppH63tiohl&Payrnent=03AO rev <br /> 00622-2: ,. . _ <br /> F:tPublic W0rk51ENGINEERING OMSION PROJECTSt1330-I.R.C:GoUna Transfer.Hub%Admiml d documentswaster Contract Documents\00622'-Contradoes Application for <br /> Payment-03-10 rev.doc Rev.05!01. <br />