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2. Updated Construction Schedule per Specification Section 01310. <br />Dated <br />STATE OF FLORIDA <br />COUNTY OF INDIAN RIVER, <br />M <br />Page 2 of 5 <br />(CONTRACTOR — must be signed by <br />an Officer of the Corporation) <br />Print Name and Title <br />Before me, a Notary Public, duly commissioned, qualified, and acting, personally appeared, who being <br />by me first duly sworn upon oath, says that he/she is the of the <br />CONTRACTOR mentioned above and that he/she has been duly authorized to act on behalf of it, and <br />that he/she executed the above Contractor's Application for Payment and Contractor's Certification <br />statement on behalf of said CONTRACTOR; and that all of the statements contained herein are true, <br />correct, and complete. Subscribed and sworn to before me this day of , 20_ <br />is personally <br />known to me <br />as identification. <br />NOTARY PUBLIC: <br />(SEAL) Printed name: <br />Please remit payment to: <br />Contractor's Name: <br />Address: <br />Commission No.: <br />Commission Expiration: <br />or has produced <br />[The remainder of this page was left blank intentionally] <br />Contractor's Application for Partial Payment - 06-09 rev - 00622 - 2 <br />F:\PublicWorks\ENGINEERING DIVISION PROJECTS\1801A IRC Courthouse Parking Garage Rehabilitation\1-Admin\Bids\Bid Documents\Bid Dcuments\DIV 0 3 Contract <br />Forms.docx — — <br />