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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 />Ditted this day of , J g, _, 2 0 <br />ContractorMidder (Firm) <br />Signature of Cont�•a�ctc��•�I�clder r- Its Agent <br />b-tt <br />Printed Name and Title <br />Subscribed and sworn to before me this C' <br />day of .3t -ip- <br />My Commission Expires . . ..... <br />Notary Public <br />County of Residence e. —2,AA, <br />TARA R. EDWARDS <br />NOTARY —PUBLIC <br />SEAL <br />STATE OF INDIANA <br />My COMMISSION EXPIRES JAN. 20,2025 <br />