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2. Updated Construction Schedule per Specification Section 01310, and <br />Dated 2/24/17 <br />STATE OF FLORIDA <br />COUNTY OF INDIAN RIVER <br />Page 2 of 5 <br />By: <br />(CONTRACTOR — mus be signed by <br />an Officer of the Corporation) <br />Ben Guettler, Manaaer <br />Print Name and Title <br />Before me, a Notary Public, duly commissioned, qualified, and acting, personally appeared <br />Ben Guettler , who being by me first duly sworn upon oath, says that he/she is the <br />_Manager of the CONTRACTOR mentioned above and that he/she has been <br />duly authorized to act on behalf of it, and that he/she executed the above Contractor's Application <br />for Payment and Contractor's Certification statement on behalf of said CONTRACTOR; and that all <br />of the statements contained herein are true, correct, and complete. Subscribed and sworn to before <br />me this 24th day of February , 20 17 . <br />—Ben Guettler is <br />(SEAL) <br />SHARON M. MORRIS <br />w* ICY COMMISSION 1 FF 136134 <br />AEXPIRES: JAY 31, 2018 <br />N�'�, oFnd" 80*dit Budy,INoory services <br />Please remit payment to: <br />Contractor's Name: <br />Address: <br />personally known" to me or has produced <br />as identification. '/� `R <br />NOTARY PUBLIC: 'AW.r/Y[. <br />t ,OM <br />Printed name: Sharon M Morris <br />Commission No.: FF136734 <br />Commission Expiration: _07/3112018 <br />[The remainder of this page was left blank intentionally] <br />00622 - Contractofs Application for Payment - 03-10 rev <br />00622-2 <br />7-101J08S102 Active Jobs%IRC GENERAL USE FIEL01Pay Appsfty App #3 - FINAL100622 - Conhactoes ApplleMion for payment - 03-10 rev.doc Rev. 05101 <br />P113 <br />