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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 6 A day of �A- 2019 <br />Subscribed and sworn to before me this <br />My Commission Expires <br />fell <br />KAT FNAnolidWce <br />Notary Public <br />State of Indiana <br />My Cornrnission Expires <br />Jtjne 5,, 2024 <br />kqR 114evl <br />Contractor/Bidder (Firm) <br />Sig 6t-ae of Contractor/Bidder or Its Agent <br />� q % <br />Dc ��®4 �qW Hd <br />o It av'. <br />Printed Name and Title <br />day of-1-09 <br />Notary <br />Version 8 -- 02/25/14 <br />