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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 ® da of cw 0�)' <br />y <br />Contractor/Bidder (Firm) <br />re of (!ronf/ ractor/Bidder or Its Ag�fen}t�, <br />Printed Name and Title 11 <br />Subscribed and sworn to before me this day of <br />MOMQUE Pam <br />My Commission Expires Flui)ft, State of MIn <br />Y <br />f;,coPK ,� u' otary Pulaiic <br />�'�°,� Cfi�aII1SSIOiI �E�;�,�„�,� <br />County of Residence 04441, <br />