Laserfiche WebLink
SURETY'S CONSENT OF PAYMENT TO CONTRACTOR: <br />i <br />The Surety, Westfteld Insurance Company <br />• i <br />,a <br />corporation, in accordance with Public Construction Bond Number 4267231 '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 />ecretary Corporate Surety <br />One Park Plaza, P. O. Box 5001 <br />Westfield Genter OH 44251-5001 <br />Business Address <br />BY: <br />Print Name:. Cabot W Lord ' <br />Title' Attomey4n-Fad % <br />(Affix Corporate SEAL) <br />$TATE 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 -Fad for <br />westfleld Insurance Co and that he/she has been authorized by, Westfield Insurance colt 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 25th day of <br />may , 20AZ_. j <br />• J� �/ r it <br />'too; <br />HotsryPWICstate ort�or�da Notary Public, Slate of <br />JamesI-:4i <br />n+rrFFf 7ff My Commission Expires:o.IM!aet1/21"18 <br />ANttkt+k>Ftlrk9rt+Y*ieir�kltfkfhhY*kA*+k*9nkie*kkinYintrtAkftMlnk+Y*#AYnV9tA sP•k�CatA•icirkkiki<k#•kktferrNk�k�Vek*+Y�1HFie*#�i:*+Y#M•ikR�itYr*irk <br />[The remainder of this page was left blank Intentionally) <br />00622 - Contractor's Application for Payment - 03-10 rev <br />i' <br />ii <br />it <br />�I <br />P74 <br />