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I hereby affirm under the penalties of perjury that the facts and inforinati on contained in the foregoing bid <br />for public works are true and correct. <br />Dated this 51" day of YI , 20ti <br />f <br />CORIE R SOUTHWORTH, <br />e""s Notary Public, State of Indiana <br />EAL"= <br />Marion County <br />*•. tz <br />Commission # 712416 <br />My Commissio-n Expires ' <br />lo" <br />April 12, 2026 <br />waft' �Iu <br />` f�rl .S .., .dalifd <br />Contractor/Bidder (Firm) <br />wjj O�� !�Cb4"j- <br />ignature of Contract o /Bidder or Its Agent <br />Printed Name and Title <br />Subscribed and sworn to before me this 50 da of 20;�l <br />My Commission Expires <br />f 4ztt��=— <br />Notary Public <br />County of Residence marioO <br />