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I hereby affirm under the penalties of perjury that the facts and infonnation contained in the foregoing bid <br />for public works are true and correct. <br />Dated this 22 day ofDecembe} 20 16 <br />Insituform Technologies USA, LLC <br />Contractor/Bidder (Fine) <br />Signature of Contractor/Bidder or Its Agent <br />Jana Lause, Contracting & Attesting Officer <br />Printed Name and Title <br />Subscribed and sworn to before uie this 22 day of December . 20 16 <br />My Conunission Expires IvO ✓ 1 '�Oflf < 1 e <br />Notary Public <br />County of Residence <br />fliZ IrS; ktl-' <br />Dc3-'1I K. JF,SP t <br />PJotary �blic - idot,ry Seal <br />srraf� oc,�nissour;i <br />St. Chfri2s Cuun;y <br />✓<Py Commission f_x,ires: Yauv. 17, 2010 <br />Co"rnission ;t 1498S5eG <br />Version 7/28/2016 Contractor's Bid for Public Works - 6 <br />