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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 F+ A day of bfze.elbl be-r , 20_�& <br />0 8 L SW( -ES -Z>�)c <br />Contractor/Bi der i <br />N" <br />Signature of Contractor/Bidder or Its Agent <br />Printed Name and Title <br />Subscribed and sworn to before me this 3� �� day of pt? flo M be r 20It, <br />My Commission Expires /U �, i �'� <br />Notary PGblic L <br />County of Residence 6L JO 5 E 13 L <br />MEREDITH REIF <br />.NorgR. <br />Notary Public, State of Indiana <br />_ <br />Saint Joseph County <br />SEAI <br />,'%lAdinr`"o <br />Commission# 639359 <br />My Commission Expires <br />October 23, 2020 <br />Version 9/1/2016 Page - 10 Public Works Quote <br />