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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 />...... day of dC7i�f2, 20 / a <br />Dated this ..................�....... 7... <br />nY� SHEA WALLACE, <br />o o Notary Public <br />SEAL A Resident of St. Joseph County, IN <br />Commission No. 684431 <br />a� My Commission Expires 04/28/2024 <br />7—/Z k,. - K C f a 7'E 2 .5 -rh Ce . <br />Contractor/Bidder (Firm) <br />...rt�r+ o�.ot torlli�lcle° or Its Agent <br />%Z>c� 7-0®0,2 y/J5 l <br />Printed Name and Title <br />Subscribed and sworn to before me this day of ..� ,, 20� <br />My Commission Expires_ <br />Notta )ublic <br />County of Residence <br />5 <br />