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I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid for public <br />works are true and correct. <br />Dated this 0J Jh day of 1- Q2Y'>• , 20�r <br />('fib Cararrx PILx x �cViCeSSi�C <br />Contractor/Bidde El exr} <br />SiP4ature of Contractor/Bidder or t�ss gent <br />L�y�c3 P <br />Fcc�m� <br />C-E• <br />�. <br />Printed Name <br />and Title ' <br />Subscribed and sworn to before me this day ofSXLtti, 20 <br />Notary Public <br />County of Residence v5t <br />minr,r <br />o^p;Pv n�a` . ij <br />N ry po"'c, S a ;KO Wof a e <br />'=SEAL'^O St, Joseph CountUpoy <br />�iANP;, eoMy�Commisnu <br />a on Expire <br />March 16, 2031 <br />