Project AGY-FYNNNN Project Name

Notice of Commencement of Public Improvement State of Ohio Standard Forms and Documents Notice is hereby given in accordance with Section 1311.252 Ohio Revised Code of the commencement of the Public Improvement identified as: Project Name Project Number Project Location Owner County Date of Contract* *Date signed by Attorney General’s Office

Public Authority Designated Representative The Public Authority responsible for the Public The representative to whom service of an affidavit may be Improvement is: made pursuant to Section 1311.26 Ohio Revised Code is:

State of Ohio Julie Barnosky Ohio Facilities Construction Commission Ohio Facilities Construction Commission 30 West Spring Street, 4th Floor 30 West Spring Street, 4th Floor Columbus, Ohio 43215 Columbus, Ohio 43215

Affidavit I certify or affirm that to the best of my knowledge, the information provided in this document is true and correct and that I am fully authorized to provide this Notice.

Affiant: Ohio Facilities Construction Commission

______[Name], [Title]

Notary The Affiant acknowledged and signed this instrument before me, a Notary Public in and for the County of , State of Ohio.

[Seal] Sworn and subscribed before me this day of , 20 .

______Notary Public

Contractor Surety Name Name Address Address City, State, ZIP City, State, ZIP Trade/GC/CM/DB

This Notice will be posted on Project Site by the Contractor and available from the Public Authority at http://ofcc.ohio.gov/Opportunities.aspx (click on “Notices of Commencement”).

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