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CI <br />• <br />KI <br />FINAL PAYMENT <br />CONTRACTOR <br />STATE OF FLORIDA <br />COUNTY OF <br />Personally before me the undersigned officer, authorized by the laws of said state to administer <br />oaths, comes — who on oath says: <br />That he is the Contractor with whom Indian River County, Florida, a political subdivision of said <br />stake, did on the ---day of _, 1999, enter into a contract for tho performance of <br />certain work, more particularly described as follows:. <br />ROUND ISLAND OCEANFRONT PARK, <br />County Project # 8622 <br />Affiant further says that said construction has been completed and the contract therefore fully <br />performed and final payment is now due and that all liens contracting directly with or dfrectly employed <br />by such contractor have been paid in full EXCEPT: <br />trie i t� AfY19a" <br />who have riot been paid and who are due the amount set forth. <br />WITNESS: (Corporate Seal) <br />(Contractor) <br />By: <br />Subscribed and sworn to before me this _ day of 1999. <br />A#est; <br />Notary Public <br />State of Florida at Large <br />My Commission expires. (Notary seal) <br />Name of Notary typed or printed <br />I herewith acknowledge receipt of Final Payment on above and do hereby certify that l have no <br />claims against the owner of said ,property. <br />Contractor <br />FINAL PAYA+Lt rr <br />FP - 1 <br />