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~ 7. The undersigned hereby authorizes and request any person, firm, or corporation to <br />furnish any information requested by the OWNER in verifications of the recitals <br />comprising the Statement of Bidder's Qualifications. <br />Dated at ~ ~• '~C~ ~.l+~ , ,this ~2-~h day of 1JUv~wil~er, 2p 0~ <br />By <br />Title: <br />STATE OF T ~(,prS <br />COUNTY OF _ L6k Wl1~c~ <br />^ra~ ~ C.-eE'1 c~-~'cx c.~-1 ~" <br />Nam/~e of Biaaer <br />~Wne r ~ 1~re5i~~~~ <br />~' Y ~~~` ~ ,being duly sworn, deposes and says <br />that he is t7 ~e~P 6 ~r~s,<a~~n <br />and that the answers to the fore oin °f ~ r ~~`~511~~C-~i ~, I~~; <br />true and correct. g g questions and all st tements therein cont fined are <br />Subscribed and sworn to before me this (2`N'` day of ~vew~io-er , 20~_ <br />~-~~.~ -_.: ~:_.".~ ~ GIB-Q~.i-~ ~GW~ <br />` ~Y ~-. Notar Public <br />~ 4. ~~ !/ s a nT~ (>~ T~as~s M commission expires: X23 2U i (~ <br />~__~. <br />12 <br /><~ i ..~ <br />