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' BK : 1675 PG : 299 <br /> �.rjo <br /> jJf� •�C y .3 tib <br /> Affix Co <br /> April L. Lively, Attorney-In-Fact & Florida Licd _ . » v = ! ,`! i <br /> Resident Agent Inquiries: (407) 834-0022 <br /> Attorney-In-Fact <br /> Guignard Company J <br /> Name of Local Agency <br /> ' 1904 Boothe Circle, Longwood, FL 32750 <br /> Business Address <br /> STATE OF FLORIDA <br /> COUNTY OF INDIAN RIVER <br /> Before me, a Notary Public, duly commissioned, qualified and acting , personally appeared <br /> ' April L. Lively , to me well known , who being by me first duly sworn upon oath , <br /> says that she is the attorney-in-fact for the Western Surety Company and that she has been <br /> authorized by Western Surety Company to execute the foregoing bond on behalf of the <br /> CONTRACTOR named therein in favor of the County of Indian River, Florida. Subscribed and <br /> ' sworn to before me this 18th day of Decemb/er�y 20 03 <br /> 21 4L ` tea TINAll9SE <br /> Tina Haase , Notary Public, State 4§100Bblic, State of Florida <br /> t My COMM exp. Dec. 2 , 2004 <br /> My Commission Expires: December 2, 2006 Comm. No. DD 188911 <br /> wrwrr:rrwrwrrwrrrrrrwrwrwrwrwrwwrwrrrrrrrrrr:rrrr:rwwa+wwwrowwewrsrwrrrrw,earrrwwrrrrrr:rrwsrtw .rrrrrwrt»rrr:x <br /> Any claims under this bond shall be addressed to: <br /> ' Name and address of Surety: <br /> Western Surety Company <br /> P.O. Box 5077 <br /> Sioux Falls, SD 57117-5077 <br /> ' Name and address of agent <br /> or representative in Florida <br /> If different from above : <br /> ' Guignard Company <br /> 1904 Boothe Circle <br /> Longwood , FL 32750 <br /> ' Telephone number of Surety and <br /> agent or representative in Florida : (407 ) 834 - 0022 <br /> ' "END OF SECTION" <br /> 0219 - Payment Bond <br /> 00612 - 5 <br /> FAEngineednglCapital Pmjects10219-K1trhing Station Trallhead1021e-00612 - Payment Bond.doc Rev. 05/01 <br /> A TRUE COPY <br /> ' CERTIFICATION ON LAST PAGE <br /> J . K . BARTON , CLERK <br />