~~It V~e' - . 0, , - Jersey City

BIDDER:
STATE OF .NJ ~ )
COUNTY OF
I,
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tLi
- JÓ~'lh ri .~t1l4 "Ja(.
FORMs - AFFTöAvlT OF öSÊsTAtus
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A. ~c-l 0 OF THE CITY OF VOo-J. -ft,tir lo L'
IN THE COUNTY OF e~ d) AND THE STATE OF AJ ;r
BEING OF FULL AGE AND DULY SWORN TO LAW ON MY OATH DEPOSE AND SAY THAT:
I AM C-CJ ()
HAVING AN ADDRESS OF 9c)
OF THE FIRM OF
tv. ;=.,Id''l
WHICH' FIRM IS AS DEFINED IN SECTION V; PARAGRAPH B.
Jõ ~fh (1 ~ ,St1lAt') lñ L
sf. ¡.4.A~wiL "v 07" 'i
I FURTHER WARRANT THAT I AM AUTHORIZED BY THE SAID FIRM TO MAKE THIS AFFIDAVIT AND WILL
PROVIDE INFORMATION REQUESTED BY THE CONTRACTING AGENCY TO DOCUMENT THE FACT THAT
THE SAD FIRM IS AS DEFINED IN SECTION V, PARAGRA~A~
SUBSCRIBED AND SWORN TO BEFORE ME THIS
""
~~
& . DAY OF
~ 20/0
, ' ,NOT~RY PUBLIC OF
MY COMMISSION EXPIRES ei/ó 201V
" . D'AN~MÄR~~2124
. .\' commisS19'n.' fNew JerseV
.,' , 'blic .j ''I ?i~ State . 'sion Expire 0 . s
~/" ivii ,.,~mrnI5V 032.014
f'iOriJor ' i,, .
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(SIGNATURE)
FRDERAAtrACHMNT.,", ' '6