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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 hue and correct. <br />Dated this 22 day ofDecembeT20 16 <br />Insituform Technologies USA. LLC <br />Contractor/Bid er (k4rm) <br />Signatiue of Contractor/Bidder or Its Agent <br />Jana Lause, Contracting & Attesting Officer <br />Printed Name and Title <br />Subscribed and sworn to before me this 22 day of Dec/ember l/ 20 16 <br />My Commission Expires NOV 1 � 20"f <br />Not Public <br />County of Residence <br />. e6tr1-/cs; M10 <br />Ccfj;?A K. JF,SPEI; <br />Notary Public - iJot3y Seal <br />SFATE CFi1glS6CUfil <br />Si. Chart=, County <br />Pfiy Comn;fsston Excites: Nov, f 7, 2013 <br />Corr:mision it I49G95dA <br />SY�•�-y <br />Version 7/28/2016 Contractors Bid for Public Works - 6 <br />