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I hereby affirm tinder the penalties of perjury that the facts and information contained in the foregoing bid <br />for public works are true and correct. <br />r) Vd <br />Dated this L y day of v e�, 20LI <br />r r n <br />S <br />of Contractor/Bidder or Its <br />Printed Name and Title <br />Subscribed and sworn to before me this ,__ 7f day of nr C 20 1 1 <br />My Commission Expires �% Z 'Z� ,vt <br />Notary Public <br />County of Residence <br />PRrAt SF MAUREEN R. DOWNING <br />dun, 9 <br />=o Notary Public, State of Ohlo <br />My commission <br />9rF of o� Expires�� <br />W <br />Ver. 13 — 6101115 <br />