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Page 2 of 3 <br /> 2. Updated Construction Schedule per Specification Section 01310,and <br /> Dated 4/28/2015 By: <br /> (CONTRACT R—must be igned by an Officer of the <br /> Corporation) <br /> DON R.MANCIL,JR. <br /> Print Name and Title <br /> STATE OF FLORIDA <br /> COUNTY OF MARTIN COUNTY <br /> Before me, a Notary Public, duly commissioned, qualified, and acting, personally appeared Don R.Mancil,Jr., who being by me first <br /> duly swom upon oath, says that he/she is the President of the CONTRACTOR mentioned above and that he/she has been duly authorized <br /> to act on behalf of it,and that he/she executed the above Contractor's Application for Payment and Contractor's Certification statement on behalf <br /> of said CONTRACTOR;and that all of the statements contained herein are true,correct,and complete. Subscribed and sworn to before me this <br /> 25th day of March,2015. Don R.Mancil,Jr.is personally know to me or has produced (a�s ide 'fication. <br /> o��aY.°pB�.� WANDASUESMART NOTARY PUBLIC: I/LA4I jy.Ul_ <br /> (SEAL) a MY COMMISSION!FF 097934 <br /> Printed Name:Wanda Sue Smart <br /> * * <br /> EXPIRES:April 25,2018 Commission No.:FF 097934 <br /> ml <br /> �l9jFOF frAY Bonded Thru Budget Notary Services Commission Expiration:04/25/2018 <br /> •3rf++*:++ r+xi. ********************* ****r******.tLhSLASAL+fAL**************rrint********»:*:**********H.**s.AA.AA:A+MN►„+s.****M• <br /> [The remainder of this page was left blank intentionally] <br /> 00622-Contractor's Application for Payment-03-10 rev.doc <br /> 00622-2 <br /> F:\Pubiic Works\ENGINEERING DIVISION PROJECTS\1219-Roseland Lake Improvements Wdmim\Master Contract Documents\00622-Contractor's Application for Payment-03-10 rev.doc <br /> Rev.05/01 <br /> 31 <br />