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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 lokt" day of MA&ml., 2011 <br />Les(ia C-ca+t'"As Tie. <br />Contractor/Bidder (Firm) .—W <br />Signature of Contractor/Bidder or Its Agent <br />AA +41, A %A)'S4-C-0 inn V cs tom( tS <br />Printed Name and Title <br />k� <br />Subscribed and sworn to before me this day of VA,-uXA , 20 1-7 <br />My Commission Expires A-so-ac K <br />Notaren lic <br />County of Residence /V�t�i <br />Version 7/31/2015 Contractor's Bid for Public Works - 6 <br />