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' RETURN WITH BID <br /> ' Illinois Department <br /> of Transportation Affidavit of Illinois Business Office <br /> 1 County Macon <br /> Local Public Agency City of Decatur <br /> ' Section Number 14-00408-00-FP <br /> Route Various <br /> ' State of :LLa-1U dl'S ) <br /> ) SS. <br /> County of ISI A6OA) ) <br /> ' <br /> 11 91D&P--rof <br /> (Name of Affiant) (City of Affiant) (State of Affiant <br /> ' being first duly sworn upon oath, states as follows: <br /> 1. That I am the EXCWT-WE USCF Pis?65�1 �r of pu4a ComfolgrilY <br /> ' officer or position bidder <br /> 2. That I have personal knowledge of the facts herein stated. <br /> ' 3. That, if selected under this proposal, A00M CO.PAIV9 will maintain a <br /> (bidder) <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. <br /> ' (Signature) <br /> -Cle7 E. du Vej <br /> (Print Name of Affiant) _ <br /> C XCe_6&7='�E Me 11 XEZtVF <br /> ' This instrument was acknowledged before me on k/7` day of 'M, N;5 o2U/ <br /> (SEAL) <br /> "OFFICIAL SEAL" <br /> SETH C QARREN <br /> ' NOTARY PUBUC,STATE OF ILLINOIS <br /> ANY COMMISSION EXPIRES 02.162017 <br /> (Signa u e of Notary Public) <br /> ' Printed 4/30/2014 BLR 12326(01/013114) <br />