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Subscribed and sworn to before me this 61 <br />My Commission Expires 1 o, 9t" b <br />JORDAN LEE NALBERDA ounty of Residence <br />IN <br />PUMIC- Not," See <br />Stitt of t <br />St <br />-- co -►resit°' ` �. �- <br />Contractor/Bidder (Finn) <br />�gnature of Cphr&o <br />idder or Its Agent <br />%i /G kf19 <br />5CGu a� <br />Printed Name and Title <br />day of Sepk'M her, 2011 <br />taryPubhe <br />