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I hereby affirm under tile 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 — day of 20 <br />Contractor/Bidder (Firrfi) <br />Signature of Contractor/Bidder or Its Agent <br />& <br />Printed Name and Title te <br />Subscribed and sworn to before nle this day of 20 <br />1�4:4 My Commission Expires kIAL-126411 i V), 'VLen1,,1%—,1' <br />NtOlt�y Public <br />SUSAN K FENDER County of Residence <br />NOTARY PUBLIC, STATE OF MP <br />COUNTY OF KkAMAZOO <br />My COMMISSION EXPIRES AtQ 3,2oig <br />ACPNG IN COUNTY Or <br />