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Division 2 - Technical Provisions, IRC -1707 <br />Under penalty of perjury, PERMITTEE declares that it has read the foregoing affidavit and the facts <br />stated in it are true. <br />FURTHER AFFIANT SAYETH NAUGHT <br />CONTRACTOR: <br />Authorized Signature: <br />Printed Name: <br />Date: <br />Work Telephone: <br />Mobile Telephone: <br />********************************* <br />STATE OF <br />COUNTY OF <br />Sworn to (or affirmed) and subscribed before me by means of ❑ physical presence or ❑ online <br />notarization, this day of 20 , by (name of <br />person making statement). <br />(Signature of Notary Public - State of Florida) <br />(Print, Type, or Stamp Commissioned Name of Notary Public) <br />❑ who is personally known to me or ❑ who has produced <br />as identification. <br />+ + END OF SECTION + + <br />Division 2 — Technical Provisions - 01025-14 <br />F:\PublicWorks\ENGINEERING DIVISION PROJECTS\1707 Indian River Blvd Merrill Barber Bridge to 53rd St Resurfacing (SCOP)\1-Admin\Bid Documents\Bid Documents\DIV <br />2 TECHNICAL PROVISIONS - IRC-1707.docx <br />