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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 8 day of December 2016 <br />Business Furnishings, LLC <br />Contracto idder (Firm) <br />ignature of Contractor/Bidder or Its Agent <br />I� (( 'k�c cc U� v� <br />Printed Name and Title <br />Subscribed and sworn to before me this 1J —' day of Z)CC&kgl Cr 2014 <br />My Commission Expires U✓ri&,-AwL4 <br />Notary Public <br />�PpY PVB JENNIFER STRANTZ <br />4� Notary Public <br />SEAL St, Joseph Coonry, Slats of lodlens <br />n ouNP Commission Esplos h_ brn�+ <br />County of Residence <br />Version 9/1/2016 Page - 9 Public Works Quote <br />116-010A Century Center <br />CEO Suites — Suite 17 Furniture <br />