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NESRA&KA <br />Good Life. Great Journey. <br />DEPARTMENT OF TRANSPORTATION <br />202108446 <br />STATE OF NEBRASKA <br />DEPARTMENT OF TRANSPORTATION <br />�%/� Affidavit <br />I, / 7<4/7p�c S , the undersigned, swear or affirm that the following <br />is true and accurate to the best of my knowledge: <br />1. I am the g44, for / `!+(p /V0(' j eh if r' <br />(title) (name of organization) <br />organized in accordance with the laws of the State of / V V h ►vsAa 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 - Depa► latent of Transportation project as noted at the close of this page. <br />Dated this 17 day of <br />State of ((-S k. -t9 <br />) ss <br />County of <br />Subscribed and sworn before me this 1 j1 day of <br />aean 92.64.4 <br />Signature <br />X9/417 6/V -S -S <br />itc: :04 <br />Print Name <br />Not <br />6'9+BiAI. NOM- Slele d *broke <br />KARLA S FANDRY <br />1 *Comm. ay. Falvey 18, 2025 <br />Public <br />Project No.: 5409(3) <br />Project Name: Five Points Intersections, Grand Island <br />Control Number: 42863 <br />Tract No.: 1 <br />