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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 7 TW day of ,rlEA 20 / 7 <br />Contractor/Bidder (Firm) <br />Signature of Con •actor/Bidder or Its Agent <br />�� cncL,sr't,�r�l - In�s�d� Ste WW6A <br />Printed Name and Title <br />Subscribed and sworn to before me this 77ve day ofF��20-LZ <br />My Commission Expires I i2- Z3 <br />Nol ary Public <br />County of Residence ��,��r, <br />FNotary <br />60LLMAN <br />Seat <br />- State of lniana <br />m County <br />Expires Nov 12, 2023 <br />Ver. 13 - 6101115 <br />