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I hereby affirm under the penalties of pet jury that the facts and information contained in the foregoing bid <br />for public works are true and correct. <br />Dated this --5— day of ", 20 le <br />Subscribed and sworn to before me this 5- <br />My Commission Expires �6 <br />County of Residence <br />Contracto idder (Firm) <br />Signature of Contractor/Bidder or Its Agent <br />Printed ame and Title <br />day of -TV /l.2 , 20 <br />Notary Pu ►c <br />MAYER JEREMIAS <br />Notary Public — State of New York <br />No. 01JE6343W <br />Qualified In Orange County <br />My Commission Expires June 06, 2020 <br />