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City of La Porte Section 00612 <br />Payment Bond Form <br />1. Corporate principals to provide the following certificates: <br />CERTIFICATE AS TO CORPORATE PRINCIPAL <br />19 <br />I,11L& C,4- _, (name) certify that I am secretary) Y <br />(title) of(company name) which is named as principal in the <br />within foregoing Bond, that JQ4 g (WT%4.►) AIL , (name of person executing <br />bond) who signed the said Bond on behalf of the principal, was then <br />_OM5 AL4. (title of person executing bond) of said principal; that I know <br />his/her signature and that his/her signature is therefore genuine; and the Bond was duly signed, <br />sea le , and atteste for and in behalf of said Corporation by authority of its governing body. <br />//yJv J- CwfW <br />Print Name <br />(Corporate Seal - required if a Corporation) <br />Subscribed and Sworn before me this�day of Y'k , 20L� <br />TILLER <br />0 #11748987 <br />Notary Public O MY Commission Expires <br />M$rch 28, 2020 <br />2. Surety shall provide a current power of attorney. <br />3. Date of Bond and surety power-of-attomey must not be dated prior to date of Agreement. <br />4. Surety companies executing bonds must appear on the Treasury Departments' most current <br />list (Circular 570 amended) and be authorizes to transact business in the State of Texas. <br />