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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 8aH day of AiOYGPtJ JGr 20 <br />Laloric ConsJroc�-on Goal IbL <br />Con(71W <br />er (Firm) <br />Signature of Contractor/Bidder or Its Agent <br />Lori cS oh r6 d , PIr�s d" <br />Printed Name and Title <br />Subscribed and sworn to before me this TV day of %VG-vfl �( , 20 � b <br />My Commission Expires 1 2 v-4 <br />of <br />County of Residence <br />QSpN <br />�p <br />0. <br />`Y•N OT,�9j,-rt� <br />S,Ap�c`�. <br />Version 7/2812016 Contractor's Bid for Public Works - 6 <br />