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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 �i � N day of �- , 20tq <br />- <br />Contractor/Bidder (Firm) <br />rre of `tor/Kidder or Its Agent <br />�1ti.rc" <br />Printed Name and Title <br />Subscribed and sworn to before me this day of �J� , 20 <br />'e <br />��y",,"�'"� <br />ob <br />). `>t%a�irlarrs� <br />Notary Public <br />alp <br />0 0hir1 <br />Z County of Residence f �corcer7 ur �Lr51i r a „�� <br />a,.�ad daYa- <br />4 tuft Lypirc-0- . . ........ <br />:. a" <br />w <br />