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The name of the partnership firm under which the above partners are operating is ......................................... <br />Give names and titles of all persons having authority to execute and receipt estimate vouchers and to conduct other <br />business for the partnership, the signatures of whom are legally binding. <br />The undersigned hereby declares that the foregoing is a true statement of the financial condition of the individual, co -partnership of <br />corporation herein first named, as of the date herein first given; that this statement is for the express purpose of inducing the party to whom it is <br />submitted to award the submitter a contract; and that any depository, vendor or other agency herein named i hereby authorized to supply such <br />party with any information necessary to verify this statement. <br />l CARBON-DANIELSON <br />U51CONSTRUCTION CO., INC. <br />............................. .......... ............................ <br />NOTE: A co -partnership must give firm name and signatures of all partners. <br />A corporation must give full corporate name, signature of official and affix corporate Brian T. Larson, President <br />Seal. <br />STATEOF ...................................... <br />SS: <br />COUNTY OF .................................. <br />Larson — Danielson Construction Company, Inc. <br />Affidavit for Individual <br />...................................................................................... being duly sworn, deposes and says that the foregoing financial <br />statement, taken from his books, is a true and accurate statement of his financial condition as of the date thereof and that the answers to the <br />foregoing interrogatories are true. <br />Subscribed and sworn to before me this............................................................ <br />(Applicant must sign here) <br />....................day of ............................ 20 ...... <br />.................................................................... <br />Notary Public <br />Affidavit for Co -Partnership <br />STATE OF ...................................... <br />SS: <br />COUNTY OF .................................. <br />...................................................................................... being duly sworn, deposes and says that that he is a member of the firm <br />of...............................................................................: that he is familiar with the books of the said firm showing its financial <br />condition; that the foregoing financial statement, taken from the books of the said firm, is a true and accurate statement of his financial <br />condition of the said firm as of the date thereof and that the answers to the foregoing interrogatories are true. <br />Subscribed and sworn to before me this............................................................ <br />(Member of firm must sign here) <br />....................day of ............................ 20 ...... <br />.................................................................... <br />Notary Public <br />Affidavit for Corporation <br />STATE OF.........INDIANA................. <br />SS: <br />COUNTY OF ......LA PORTE................ <br />............Nick D. Larson ........ being duly swom, deposes and says that that he is a member of the firm of ...... Vice -President..........; of the <br />.............Larson -Danielson Construction Co., Inc.............., the corporation described in and which executed the foregoing statement; that <br />he is familiar with the books of the said corporation showing its financial condition; that the foregoing financial statement, taken from the <br />.......... .%' f and that the books o the said firm, is a true an accurate statement o the mania condition o the said corpora ate t ereoanswers to the foregoing interrogatories are true. LARsothat theLSON <br />Subscribed and sworn to before me thisOCONSTRUCTION CO., INC. <br />25th , day of ...July, 2023 (Officer must sign here) <br />....... ....... Brian T. Larson, President <br />.............................................................................. <br />Michele C. Dzielinski, LaPorte County Resident My Commission Expires: September 8, 2023 <br />, ,, MICHELEe on DEryL"' 15 <br />�,p, September8,2 <br />