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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 Al day of /I r+ ., 20Z / <br />s4,"Y Pre CAMJN T SFtlrl W <br />n Notary Public <br />SEAL A Resident of St. Joseph Cow+ IN <br />Commission Number NP0715093 <br />OF 000My Commission Expires 0713112D26 <br />a �n , In <br />Contractor/Bidder (Firm) <br />Signature of Contractor/Bidder or Its Agent <br />/ <br />� hr31•a-j IiC.fllI rt. rc£ ff-SiGLe/i� <br />Printed Name and Title <br />Subscribed and sworn to before me this q of � , ZU <br />My Commission Expires` <br />—Uh j <br />Notary Public <br />County of Residence uam <br />