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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 ...................... day of i 6 , I , 2019 <br />Contractor/Bidder (Firm) <br />linaiure of Co...._ .... _._._._.._ <br />ntractorBidder or Its Agent <br />" ......'.r....... . .w <br />Printed Name and Title <br />Subscribed and sworn to before me this day of 1 w 20 <br />My Commission Expires _ ..... <br />Notary Public <br />fill <br />County of Residence O C2-'{� <br />..... <br />Andrea S Bible, Notary Public <br />SEAM, 1 <br />Morgan County, State of indite <br />Commission No. 6M184 <br />aiiM <br />My Commission Expires, w3t2on <br />