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Page 3of5 <br />SURETY'S CONSENT OF PAYMENT TO CONTRACTOR: <br />The Surety, WESTFIELD INSURANCE COMPANY <br />,a <br />corporation, in accordance with Public Construction Bond Number 6086208 , 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 />WESTFIELD INSURANCE COMPANY <br />Secretary Corporate Surety <br />One Park Circle, P.O. Box 5001 <br />Westfield Center, Ohio 44251-5001 <br />Business ess <br />BY: <br />Print Name: Cabot W. Lord _ <br />Title: Attorney -in -Fact <br />(Affix Corporate SEAL) <br />STATE OF FLORIDA <br />COUNTY OF INDIAN RIVER <br />Before me, a Notary Public, duly commissioned, qualified, and acting, personally appeared <br />Cabot W. Lord , to me well known or who produced <br />as identification, who being by me first duly sworn <br />upon oath, says that he/she is the Attorney -in -Fact for <br />Westfield Insurance Co.and that he/she has been authorized by Westfield Ins. (-f-, to approve payment <br />by the OWNER to the CONTRACTOR of the foregoing Contractor's Application for <br />Payment. Subscribed and sworn to before me this 12th day of <br />October , 20 16 <br />ow Note Public <br />ry sraie of Fbrida <br />James T Mill No P blic, State of FC <br />My Commission FF 171767 My Commission Expires: i t-.2 I - d o 1 / <br />ow Expires 11121/2018 <br />a <br />,ti-hk*,�i� **,kxwrtw*lkw*kwwx*w*w,w ***ww*,rw**�kw-rww>t�R+M+r+r w�ylww�tw,v*w* k*,w,twrt,kw r*w*Irw,tic+tx�4,ilr7� www,tir �**,r*iyr*,kw� *w* <br />[The remainder of this page was left blank intentionally] <br />00622 - Contractor's Application for Payment - 03-10 rev <br />00522-3 <br />FVLdic Works'ENGINEERING DMSION PROJECISW72620M Ave aid Mh SI InImeclw^ I nprovemerelAdmmltid docur•enlslMasler ConBad Ducumens%DO6Z2 • Cent -actor's <br />Accdlcal�n for Pa)r *ri -03. 13 rav dec Rev OMI <br />