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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 day of f-yhQ , 20 <br />Contractor/Bidder (Firm) , <br />Signature of Contractor/Bidder or Its Agent <br />7,rq <br />Printed Nance and Title <br />Subscribed and sworn to before me this day of ru, e , 20 1 <br />My Commission Expires,'1 <br />Notary Public <br />County of Residence C}c¢�1/ f <br />MAYER JEREMIAS <br />Notary Public - State Of New York <br />No. OIJE6343141 <br />Quatlffsd In Orange County <br />My Commission Expires June 08, 2020 <br />7 <br />