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NEBRASKA <br />Good Life. Great Journey. <br />DEPARTMENT OF TRANSPORTATION <br />1, j41f r 4 44/7 <br />is true and accurate to the best of my knowledge: <br />201904191 <br />STATE OF NEBRASKA <br />DEPARTMENT OF TRANSPORTATION <br />Affidavit <br />, the undersigned, swear or affirm that the following <br />1. I am the /7117464/ for / e344'.C% ) f 14 / 4 e< <br />(title) (name of organization) <br />organized in accordance with the laws of the State of 14✓,,rij� and/ or <br />lawfully operating in the State of Nebraska; and <br />2. In that capacity or by resolution of the <br />(governing body) <br />dated , I am authorized to sign any and all documentation on behalf <br />of the above named entity regarding the sale or use of property rights in general or specifically <br />with the State of Nebraska - Department of Transportation project as noted at the close of this page. <br />Dated this V day of <br />State of /V 4.‘.- <br />County of / t <br />) ss <br />,201'99 . <br />Subscribed and sworn before me this / day of ✓ ", / <br />,Signature <br />Print Name <br />GENERAL NOTARY • State of Nebraska <br />JEFFREY J. WHITAKER <br />My Comm. Exp. January 24, 2022 <br />, 20 / 9 . <br />Project No.: 7040(25) <br />Project Name: Grand Island Northwest <br />Control Number: 42322 <br />Tract No.: 1 <br />