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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 .,_..._. % 7 7_....... day of ; 20 1 �/ <br />Si- ILA WALLACE, <br />c Notary Public <br />• SEAL A Resident of St. Joseph County, IN <br />Commission No. 684431 <br />OF My Commission Expires 04/28/2024 <br />�.��...Al�.�............__._...�. <br />Contractor/Bidder (Firm) <br />�t t�vre of ° ��n � � w�°��"C��a�clm��r• or Its Agent <br />Printed Name and Title <br />Subscribed and sworn to before me this day of ��� f� 20 <br />P <br />JMy Commission Expires. _...................... ........ .._.....___.... <br />Notar Public <br />County of Residence <br />