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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 D44L day of 20_a <br />Co tract 1 der( <br />Signature of Contractor/Bidder r Its Agent <br />Printed Name and Title <br />Subscribed and sworn to before me this day ot 20 CS <br />9 1 <br />My Commission Expires fis /),I <br />vikJ1111110, --T-TNotary Public <br />SEAL <br />LASEPN G <br />� 41C <br />County of Residence erl <br />I <br />Version 10/17/2017 Contractor's Bid for Public Works - 6 <br />