Laserfiche WebLink
in this CONTRACTOR 9s APPLICATION FOR PAYMENT, <br /> TO BE EXECUTED BY CORPORATE SURETY: <br /> Attest: <br /> ' <br /> Secretary Corporate Surety <br /> ' Business Address <br /> BY: <br /> Print Name : <br /> Title : <br /> STATE OF FLORIDA (Affix Corporate SEAL ) <br /> COUNTY OF INDIAN RIVER <br /> ' Before me a <br /> Notary Public, duly commissioned , qualified and acting , personally <br /> appeared , to me well known , who being by <br /> me first duly sworn upon oath , says that he is the <br /> for and that he has been authorized by <br /> it to approve payment by the OWNER to the CONTRACTOR of the foregoing <br /> Contractor' s Application for Payment . Subscribed and sworn to before me this <br /> day of 20 <br /> Notary Public, State of Florida <br /> My Commission Expires : <br /> [The Remainder of This Page Was Left Blank Intentionally] <br /> 00622 - Contractor's Application for Payment ADDENDUM #2 — ADDENDUM #1 <br /> 00622 - 3 <br /> Fe.ftblic WorksWetthMlStonnWater Projects\Glfford East\Construction ContractSidding & Contract Documents\Bidding & Contract Documentst00622 - Contractors Application <br /> for Payment ADDENDUM #2.doc Rev. 05/01 <br />