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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 day of ,.r° , 20 <br />Contra tor7�,,F�� <br />S' e of Contractor/ idder or Its Agent <br />Printed Name and Title <br />Subscribed and sworn to before me this r (J:�� day of rr , , 20 j <br />My Commission Expires 9 - 21-1 1 <br />Notary Public <br />County of Residence <br />t:•'"P °4 : <br />DEBORAH E. HEG(j INSKI <br />='• <br />St Jbsoph Cv, <br />5F^` .` <br />�?rFaF <br />My Commission Expires <br />i�Pe�. <br />September 21 2017 <br />