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TO BE EXECUTED BY CORPORATE SURETY: <br /> Attest: <br /> Secretary Corporate Surety <br /> Business Address <br /> (Afix Corporate SEAL) <br /> Attorney- In- Fact <br /> Name of Local Agency <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 /> to me well known , who being by me first duly sworn upon oath , says <br /> that he is the attorney-in -fact for the and that he has been authorized by <br /> to execute the foregoing bond on behalf of the CONTRACTOR <br /> named therein in favor of the County of Indian River, Florida . Subscribed and sworn to before me <br /> this day of , 20 <br /> Notary Public, State of Florida <br /> My Commission Expires : <br /> [The remainder of this page was left blank intentionally] <br /> 4/09/03 PAYMENT BOND — ADDENDUM # 1 00612-5 <br /> R\Public WorksWeithWStorm ater Projects\Gifford East\Construction Contract\Bidding & Contract Documents\Bidding & Contract <br /> Documents\00612 - Payment Bond - ADDENDUM #1 .doc <br />