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I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid <br />for public works are true and correct. <br />Dated this 4th day of May , 20 17 <br />Subscribed and sworn to before me this 4th <br />My Commission Expires 7 / 13 /2022 <br />County of Residence <br />Herrman & Goetz,Inc. <br />Contractor/Bidder (Firm) <br />b <br />Signature Contra r/Bidder or Its Agent <br />Thomas J. Herrman, President <br />Printed Name and Title <br />day of May , 20 17 <br />Notary Public <br />St. Joseph <br />Version 4/17/2015 Contractor's Bid for Public Works - 6 <br />