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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 z % day of 5 20_,49 <br />W <br />Contractor/Bidder or Its Agent <br />Printed Name and Title <br />Subscribed and sworn to before me this day of A.' 20 19 <br />My Commission Expires _() <br />Notary Public <br />County of Residence 0 <br />_ A-2414 AILL <br />--— — — — <br />— —— " S <br />neside� Ml Co.,pt <br />g <br />tiny commission expires � <br />t9ClQber 2M u <br />