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Page 2 of 5 <br />2. Updated Construction Schedule per Specification Section 01310. <br />Dated <br />(CONTRACTOR — must be signed by <br />an Officer of the Corporation) <br />Print Name and Title <br />STATE OF <br />COUNTY OF <br />Sworn to (or affirmed) and subscribed before me by means of ❑ physical presence or ❑ online <br />notarization, this day of 20_, by <br />(name of person making 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 />[The remainder of this page was left blank intentionally] <br />Contractor's Application for Partial Payment - 06-09 rev - 00622 - 2 <br />F:\Public Works\ENGINEERING DIVISION PROJECTS\1707Indian River Blvd Merrill Barber Bridge to 53rd St Resurfacing (SCOP)\S-Admin\Bid Documents\Bid Documents\DIV 0_1_Bid and Contract <br />Doc IRC-1707.dacx <br />