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2. Updated Construction Schedule per Specification Section 01310. <br />Dated <br />STATE OF <br />COUNTY OF <br />By: <br />Page 2 of 5 <br />(CONTRACTOR — must be signed by <br />an Officer of the Corporation) <br />Print Name and Title <br />Sworn to (or affirmed) and subscribed before me by means of ❑ physical presence or ❑ online <br />notarization, this day of 20 , by (name of person making <br />statement). <br />(Signature of Notary Public - State of Florida) <br />(Print, Type, or Stamp Commissioned Name of Notary Public) <br />❑ who is personally known to me or ❑ who has produced <br />as identification. <br />Please remit payment to: <br />Contractor's Name: <br />Address: <br />**************************************************************************************************** <br />[The remainder of this page was left blank intentionally] <br />00622-2 00622 - Contractor's Application for Payment - 03-10 rev <br />F:\Public Works\ENGINEERING DIVISION PROJECTS\1927 Round Island Beach Access\1-Adm1n\Bids\Bid Documents\Master Contract Documents\00622 - Contractor's Application <br />for Payment - 03-10 rev.doc Rev. 05/01 <br />