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Under penalty of perjury, Permittee declares that it has read the foregoing affidavit and the <br />facts stated in it are true. <br />FURTHER AFFIANT SAYETH NAUGHT <br />Permittee: <br />Authorized Signature: <br />(if signing as Owner's Agent, attach Letter of Authorization to Sign from Owner) <br />Printed Name: <br />Date: <br />Work Telephone: _ <br />Mobile Telephone: <br />Email Address: <br />The foregoing instrument was subscribed and sworn to before me this day of <br />, 20_ by , <br />who is personally known to me or has produced as <br />identification and who did take oath. <br />My Commission expires: <br />Notary Public State of Florida at Large <br />+++ END OF SECTION+++ <br />Last .revised: 6/29/2018 3 <br />£\public works\engineering division projects\1760 victor hart sr. complex drainage improvements\1-admin\bids\bid documents\irc= <br />1760_appen_c_20180811doc <br />