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I hereby affirm under the penalties of perjury that the fads and information contained in the foregoing bid <br />for public works are true and correct. <br />Dated this day of , 20zp <br />Subscribed and sworn to before me this <br />My Commission Expires <br />County of Resident <br />Contractor/Bidder (Firm) <br />_7 <br />Signature of Contractor/Bidder or Its Agent <br />Printed Name and Title <br />MONICA JO MILHOLLAN <br />➢4 —•—' <br />SPAL <br />Wells County <br />' <br />My Commission Expires <br />iA <br />February 20, 2022 <br />Version 7/3112015 Contractor's Bid for Public Works - 6 <br />