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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 />V, Dated this // _ day of - L 201_� <br />Contractor/Bidder (Firm) <br />Signature of Contractor/Bidder or Its Agent <br />✓ I leeJ,,lI d <br />Printed Name and Title <br />Subscribed and sworn to before me this .� day of YI z2 <br />My Commission Expires o5- a(0 -coati <br />—� Io ary Public <br />County of Residence �VE;ep 1 <br />go-- <br />C1155ANDMMTTERSON, <br />Notary Public <br />A flesident of St. Joseph Cou ty, IN <br />Commission Number NP0733961 <br />MyCwrnission Expves O5/26/z029 <br />