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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 �)' 1 day of , 20! / <br />Contra or/Bidder (Firm) <br />Signature of Contractor/Bidder or Its Agent <br />1V) f � eo_ r' is&� S des'_ a e <br />Pri ten d Name and Title <br />Subscribed and sworn to before me this OV day of x9awe 20—L <br />My Commission Expires G¢ �'� �� <br />of ry Public ,,�� 2 t,3 Gv 4,1"1 e r"O', <br />County of Residence /1�4RId,�! <br />Ver. 12 — 9/16/13 <br />