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RE7URN WiTH BtD <br /> ��ais t3ep�tmer�t <br /> af Tran�s�x,��an Af�idavit ofi INinois Business Office <br /> County Macan <br /> Lacal Public Agency Ci of Decatur <br /> Secfion Number 19-00908-00�-FP <br /> Route Variaus Streets <br /> State of �(,�(�()� � } <br /> ) ss. <br /> County of �,J�,,j� (�j� ) <br /> �, �5 B r"a l� t *. (f Il�Il� of �'��'�1.�..�.. , �!1!,(I�J S , <br /> {Name of Afliant) {City of Affiant) (State of Affiant <br /> being first dufy sworn upan oath, states as foliows: ���� ���?'� � � <br /> 1. That i am the � ��G ���( `f of �'�t S(Oh1 ��dd"��� '�S L• <br /> officer or position <br /> 2. That I have personai knawiedge of the fact��e�n�sta�ed�F <br /> � � <br /> 3. That, if seiecfed under this propasai, r„3 �,.� G. , wiH maintain a <br /> (bidder) <br /> business o�ce in the State of illinois which wiit be lacafed in 11,l�,J�C�E�� County, liiinois. <br /> 4. That this business o�ce wili serue as the primary place af empfoyment for any persans employed in the <br /> construction contempiafed by#his proposal. <br /> 5. That this Affidavit is given as a requirement af state law as provided in Section 3d-22(8}of the IOinois <br /> Procurement Cade. � ��� <br /> (Signature} <br /> l�P���" �. �JN'1�`�,�(L�. ��.+�5(� <br /> (Print Name of A�ant) <br /> This instrument was acknowledged before me on G���day af , � . <br /> {SEAL) <br /> "OFFICIAL SEAL" <br /> TIFFANY C CRAW <br /> IVOTARY PUBttC.STATE OF iL�tltOtS <br /> �r co�M�ss�eN�x��a�s os�sazass <br /> Signature otary Public) <br /> Printed 4/15l2019 BLR'l2326(01I08114) <br />