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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 2.I + day of MARCH, 20 17 <br />R' V-GA+ C:L G r 1 N 1✓. <br />Contractor/Bidder (Firm) <br />a it, �& <br />Signature of Contractor/Bidder or Its Agent <br />IUA MIU,E12- V I W PRemtsm+ of SALE5 <br />Printed Name and Title <br />St <br />Subscribed and sworn to before me this 2l day of , 20 l� <br />My Commission Expires to e1 gl- — t I NA �/✓� <br />Notary P iblic <br />County of Residence , 7�A1 A-C, <br />DAVID M. KOWALSKI <br />`eA,'k'YYIN,, <br />a,ouayS ,Notary Public, State of Indiana <br />St. Joseph County <br />sEnt <br />Commission p 666745 <br />My Commission Expires <br />October 01, 2022 <br />Ver. 13 - 6101115 <br />