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r - <br /> i RETURN WITH BID <br /> Illinois Department <br /> ' of Transportation Affidavit of Illinois Business Office <br /> County Macon <br /> ' Local Public Agency City of Decatur <br /> Section Number 18-00808-00-FP <br /> Route Airport Rd <br /> ' State of ) <br /> ss. <br /> County o,�f, <br /> kw ,/6• ^ ' ) <br /> I, �'V 1JU�� of ',�1��( lA l S <br /> ' (Name of Affiant) (City of Affiant) (State of Affiant <br /> being first duly sworn upo oath, states as follows: n(`N (►,01A , A <br /> 1. That I am the V I V Q Wei t W riT of WASIAN <br /> ' officer or position bidder <br /> 2. That I have personal knowledge of the facts have stated. <br /> 3. That, if selected under this proposal, N �l C,. , will maintain a <br /> (bidd ) <br /> business office in the State of Illinois which will be located in -- [�`�� County, Illinois. <br /> 4. That this business office will serve as the primary place of employment for any persons employed in the <br /> construction contemplated by this proposal. <br /> 5. That this Affidavit is given as a requirement of state law as provided in Section 30-22(8) of the Illinois <br /> Procurement Code. r4e <br /> (Signature) <br /> AL4l PQ-C�fl� <br /> (Print Namd of Affiant) <br /> This instrument was acknowledged before me on ��dayof <br /> ' SEAL "OFFICIAL SEAL" <br /> (SEAL) TIFFANY C CRAW <br /> NOTARY PUBLIC,STATE OF ILLINOIS <br /> MY COMMISSION EXPIRES 06.24.2019 <br /> ig ture o Nota P blic) <br /> ' Printed 5/4/2018 BLR 12326(01/08/14) <br />