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Witness: Carolina Green Corp. _ _ <br />Contractor. (Trade ar Corporate t~~me <br />- i3y ~` } <br />(p'ropf iefoi'ship or Partnership} - J <br />Attest: (Corporation} Title: /).~1.~~- ~~~ tom. <br />-~ fires. nr Vice res_ onty} <br />Owner, Partner, or Corp. <br />sy: - ~ _ ~.~.~ <br />Titt~: SFae~-G/ a. <br />MCorp..' Sec. or A ,. orxi~ ~ <br />(Corporate Seal} <br />TRAVffi.ER.S [•.~s~uL~rv AND SIIRErY <br />COMPANY OF AMBILICA <br />(Surety. Company} <br />Witness : By : I~ . <br />?;r;`~~ .~!( (`' G'~ :~~rl Title'• Doffia ~. Ashley <br />Jennif~r C. Ho - (Att4mey in FaGtj <br />Countersigned: <br />•~ ; r; ~ ,%~.~~_ (SuretyGorpocate Seal} <br />_Jeonifer .Hoehn ' <br />(N.C; L'censed Resident Agent) <br />Wachovia Insurance Services <br />P.O. Box 220748 <br />Charlotte, NC 28222 <br />Name- and Address-Surety Agency _ <br />Travelers Casualtty and S~sety Company. <br />of America <br />P.O. Boa. 473550 <br />Charlotte, NC 28247 <br />Surety Company Name and NC, <br />~2egivnai or Branch r?ffiae Address <br />• <br />