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f hereby affnn under the penalties of perjury that the facts and information contained in the foregoing bid <br />for public works are true and correct. <br />r � <br />Dated this day of �, 20 <br />Contract9 idder (Firm) <br />nature of Contractor/Bidder o is Agent <br />Printed Name and Title <br />Subscribed and sworn to before me this day of'u <br />My Commission Expires LL'k <br />Notary Publi <br />County of Residence <br />Ver. 13 — 610111.5 <br />