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use steel products or foundry products on this project if awarded. I understand that violations <br />hereunder may result in forfeiture of contractual payments. <br />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 � S �h day of 1 2011 <br />Subscribed and sworn to before me this _ <br />My Commission Expires MoZv� <br />County of Residence <br />JENNE'1TIE.ACKERMAN <br />NOTARY PUBLIC ; STATE OF MICHIGAN <br />COUNTY OF V,�N,BURRN <br />My Commission Expires May 31, 2022 <br />Acting, in the County of Van Buren <br />one i , LGn L,,L z� GL iU <br />Contractor/Bidder (Firm) <br />ure of Chj <br />o/ ctfor/Bidder or Its Agent <br />tiv <br />( <br />Printed Name and Title <br />Of <br />otary Public �✓ <br />1 Akre � <br />2011 <br />Version 8 — 02/25/14 <br />