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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 Z 7-4, day of rllcv 20 ! 7 <br />Con ractor/Bidder (Firm) <br />K <br />Signature of Contractor/Bidder or Its Agent <br />Qej ,V. tit 4AV%4V -, C>rt,v,J,-'L r'✓ na� of <br />Printed Name and Title <br />Subscribed and sworn to before me this �_ day of MOW 20A <br />My Commission Expires 01 lay 1;-1 /W4 <br />Notary public <br />County of Residence L z) <br />Ver. 13 — 6101115 <br />