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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 day of 20 0 % <br />-(a r 0 1 tet ode " Z.- <br />14 <br />of Cd' t-or/Bidder or Its Agent <br />Printed Name and Title <br />Subscribed and sworn to before me this <br />My Commission Expires ilkC <br />County of Residence <br />Version 8 — 02/25/14 <br />