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SURETY'S CONSENT OF PAYMENT TO CONTRACTOR: <br />The Surety, Westfield Insurance Company <br />,a <br />corporation, in accordance with Public Construction Bond Number 5582831 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, OH 44251-5001 <br />Business ress <br />BY: <br />Print Name:. Cabot W. Lord <br />Title: Attorney-inf--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 insurance co it 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 />March 20 18 <br />Notary Public State or Florida <br />James T Hill Notary Public, State of L <br />My Commission FF 171767 <br />'+» F Expires 11/2112o18 My Commission Expires: 11- <br />**rkrF <br />[The remainder of this page was left blank intentionally] <br />00622 - contractor's Application for Payment - 03-10 rev <br />00622-3 <br />FdPublic WorWENGINEERING DIVISION WPROJECTS11049 0th St sidewalk Improvements (58th Ave to 21st Coun)%Admimlbld documentslLAP DocumentsVAaster Contract 43 <br />DOmentsW0622 - Contractors Application for Payment- 03-10 rev.doc Rev. 05101 ti <br />