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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 —JV�, day of A� , 200 <br />Contractor/Bidder (Firm) <br />Si �, of Contractor/Bidder or Its <br />Agent <br />Im e� i ,0-04 . m " - Si9CE�S <br />Name and Title. <br />i. <br />Subscribed and sworn to before me this <br />My Commission Ex Tres <br />,--7/1 �43 <br />County of Residence <br />