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01/08/2019
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01/08/2019
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Last modified
12/31/2019 11:14:42 AM
Creation date
2/19/2019 9:38:57 AM
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Meetings
Meeting Type
BCC Regular Meeting
Document Type
Agenda Packet
Meeting Date
01/08/2019
Meeting Body
Board of County Commissioners
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SURETY'S CONSENT OF PAYMENT TO CONTRACTOR: <br />The Surety, LIBERTY MUTUAL INSURANCE COMPANY <br />Page 3 of 5 <br />,a <br />corporation, in accordance with Public Construction Bond Number 016215860, 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 />C)(\\Gv� `A(N\A''✓ LIBERTY MUTUAL INSURANCE COMPANY <br />Secretary Lian Mier, Witness <br />STATE OF FLORIDA <br />COUNTY OF INDIAN RIVER <br />Corporate Surety <br />175 Berkeley Street <br />Boston, MA 02116 <br />Business Address <br />BY: <br />Print Name: Benjamin A. Stahl <br />Title: Attorney -in -Fact <br />(Affix Corporate SEAL) <br />Before me, a Notary Public, duly commissioned, qualified, and acting, personally appeared <br />Benjamin A. Stahl, to me well known or who produced well known as identification, who <br />being by me first duly sworn upon oath, says that he/she is the Attorney -in -Fact for <br />LIBERTY MUTUAL INSURANCE COMPANY and that he/she has been authorized by <br />it to approve payment by the OWNER to the CONTRACTOR of the foregoing Contractor's <br />Application for Payment. Subscribed and swom to before me this 3rd day of <br />December , 20 18 <br />ry,Publ c Std of GEORGIA <br />Mommission Expires: June 12, 2022 <br />[The remainder of this page was left blank intentionally] <br />016215860 J -D 00622 - Contractor's Application for Payment-04-final.doc <br />00622 - 3 <br />C: Wsers1msignontAppOataLLxalWiaosoR4WindowstTemporary Internet FilestContenl OutlooktRT2AMM041016215860 J-0 00622 - Cor 2aGofs Apphcat on for Payment -04-final doc <br />Rey 05/01 <br />102 <br />
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