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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 00 1 � day of FA- 2019 <br />kHflelqs <br />Cont, der (Firm) <br />SignStud of Contractor/Bidder or Its Agent <br />[qq, �JOYA t <br />Printed Name and Title <br />Subscribed and sworn to before me this day of tf4" -1 CLfr- 20 <br />71 <br />My Commission Expires <br />Notaiy Pu <br />County of Residence <br />KATHY A. REINHARDT <br />Notary Public <br />State of Indiana <br />My Cornrnission Expires <br />June 5, 2024 <br />Version 8 — 02/25/14 <br />