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I hereby affirm under the penalties of perjury that the facts and infonuation contained in the foregoing bid <br />for public works are true and correct. <br />Dated this ON day of e:, , 20/ <br />Contractor/B dd r (F <br />'N MY COMMISSION #FF099586 S gna ure of Contractor/Bidderor Its Agent <br />" � o EXPIRES March 9, 016 <br />DE(407) 398-0153 FlariclaNcalaryService.c�raa U. r o a <br />Printed Name and Title 5�, Nrkchlt, <br />Subscribed and sworn to before me this day of C" , 20 <br />My Commission Expires <br />Notary Public <br />County of Residence A /A <br />Ver. 13 — 6101115 <br />