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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 <br />/correct. <br />Dated this / day ofJ40 , 20/ 7 <br />"OFFICIAL SEAL" <br />Iris L Gonzalez <br />Natarl uFgo State of Illinois <br />rnirsior, s F . / <br />.�.. , ,..,.r. Pir /3- 20 f g <br />aJ 1 �L4.7a "L (G , I I i .dY�s <br />Contractor/Bidder (Firm) <br />Sign ture of Contractor/Bidder or Its Agent <br />Printed Name and Title <br />Subscribed and sworn to be ore me this day of 200 /�7 <br />My Commission Expires lam! <br />Notary Public <br />County of Residence <br />