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0 <br />0 <br />BY: <br />(Affix Corporate Sea[) <br />Attorney -In -Fact <br />Name of Local Agency <br />Business Address <br />Telephone <br />STATE OF FLORIDA <br />COUNTY OF INDIAN RIV#_R <br />Before me, a Notary Public, duly commissioned, qualified and acting, personally appeared <br />to me well known, who being by me first duly <br />sworn upon oath, says that Ile is the attorney-in-fact for the <br />and that he has been authorized by � to execute the <br />foregoing bond on behalf of the CONTRACTOR named therein in favor of the County of Indian <br />River, Florida. Subscribed and sworn to be for me this day of , 19—. <br />My Commission Expires: <br />Notan,f Pl-Vic, Slate of Rarida <br />_. <br />Pavment Bond <br />