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1 hereby affirm under the <br />penalties <br />of perjury that the facts and information contained in the foregoing <br />bid for public <br />works are true and correct. <br />Dated this (- P lh day of Fes¢ , 20�� <br />Dnb <br />�emnsLY�lbi/lCd �NIC4S�) f C, <br />Contractor/. iffcfer (Firm) <br />S nature of Contractor/Bidder or Its Agent <br />Printed Name and Title <br />Subscribed and sm orn to before in _n�h day of �R� 7. , <br />My Commission Expires s' -� <br />Notary Public <br />County of Residence 3 � • 'tsotJ "-y <br />� uuurn. <br />o�Pev n�A, CAROL A. LASKOWSKI <br />o; ;Notary Public, State o' Indiana <br />t�SEAL^'. St. Joseph County <br />,'Rc Commission Number NP0747840. <br />%�/40 ;pHP�o° My Commission Expires <br />March 15, 2031 <br />24 <br />