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I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid <br />for public works are true and correct. <br />Dated this Z 3rd day of A-J 201 & <br />Cdw.i rcl J. LJL,-�, Z:, <br />Contractor/Bidder (Firm) <br />Sign.*rel of Contract r/Bidder or Its Agent <br />Jeff` GG,- er, Jr. <br />Printed Name and Title <br />Subscribed and sworn to before me this 23' day of J �J— 20 l <br />My Commission Expires ;U 2 2_ <br />County of Residence <br />Not6 Public <br />S4, J.:,f-,O1, <br />`W •- <br />Version 7/31/2015 Contractor's Bid for Public Works - 6 <br />