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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 13th day ofDecember2o 16 <br />'. GpR1'®Rq7 .°�� <br />0. <br />e <br />SEAL;® <br />Subscribed and sworn to before me this 13th <br />My Commission Expires March 1, 2020 <br />County of Residence <br />Ziolkowski Construction, Inc. <br />Contrac <br />t <br />or <br />/B <br />i <br />d <br />der (Firm) <br />Signa e of Contractor/Bidder GAgent <br />Bill Favors, President <br />Printed Name and Title <br />day of December 2016 <br />1 o a A o Aka <br />Notary Public Shannon Reidenbach <br />St Joseph <br />LMy <br />SHANNON REIDENBACH <br />Notary Public- Seal <br />State of Indiana <br />ommission Expires Mar 1, 2020 <br />Version 10/18/2016 Contractor's Bid for Public Works - 6 <br />