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<br />A F F Z D A V I T <br />STATE OF OHZO • ? <br />COUNTY OF CUYr1gpGA) <br />deposes and sa s as? ~ <br />3' follows: ' beiIIB first <br />He./??T is ?? ? duly sworn, <br />? C`n.c,4?lh <br />the City of North Ol :as <br />..??.. =-V <br />mste-d f _l. of <br />o r (. ? - VC " ///aaf - <br />. ? ' • ? {..- J / ?/W ? ? V ? v <br />2. <br />time the bid?L-1 J1J1•4_ ?? ? <br />as suDmltted was no <br />t <br />on the general tax list of ?ith an,ir de2inqueat ?harged at the <br />Personal propert Personal property taxes <br />2. (3) Y ia Cuyahoga County. <br />or <br />the bid was subiaitted <br />general tax list W??eliuquenr ?a?TKed at the e <br />of (S) $ of personaZ_p?,?rty ia?Cuynaal property taxes on timthe <br />taxes and (6) $ ? hoga County in the <br />for due and amount <br />unpaid pena.l.ti-es and unPaid delinquent <br />- interes thereon, for <br />due and <br />that 3. (3) . .???? <br />, as required by Section $? <br />statement 9,042 - un?erstands and a <br />indicates that this ?f th"e Ohio <br />R grees <br />personal contractQr evised Code, if this <br />Olmsted WProPerty taxes, the Finance D- iS charged with <br />iil transmit lrector of the any delinquent <br />and that a coPy of thiS copy ?f this statement ?jty °f vorth <br />contract, and no statement i,,il1 also tO the County Treasurer, <br />payment shail be be incorpo <br />unless tnis sta?e?ent made with rated into the <br />has been so incorporated sPect to any contract <br />- / j / 4 as a part thereof, <br />? Bi?iiO? <br />m-e and - - <br />stibs ribed in my presence this ? • <br />-- , <br />I9 ?- : - day of <br />? <br /><NOrY Public <br />? Instructions <br />• Insert name cf <br />?• Insert ?i?1e Person making statement. <br />(President, Secr`_tar <br />Insert name of Coatractor. y. etc.), <br />• Znsert nature of contract <br />• Insert principaZ amount of ?r Pubji? improvement <br />if any_ delinquent personal <br />- Insert penalties and <br />P?opert interest <br />y taxes, if any. <br />Cross out Pa:agra h 2 <br />?..?i 1? 7,?e?• :°?!'?...,T11 <br />I.'.j??'??: '•t:,. ._. ......? .. '_•4::. ?t:i??/?! V,J. <br />._"1: ...,. .. ? _ , .. ?..,.'C? ?'• s 10 <br />rendered. <br />property taxes, <br />owed for deiinquent personal <br />P which does not <br />apply.