Laserfiche WebLink
may result in forfeiture of contractual payments. <br />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 I Z 'I -day of 318 , 20 \7 <br />Subscribed and sworn to before one this % <br />My Commission Expires (o <br />t /,7 <br />Couniy of F csidence <br />4wJ �-s lz�/ /C> s <br />Contractor/Bidder ( irm) <br />Signature of Contractor/Bidder or Its Agent <br />S'iC�JC-? ��C�?��S �1C-� �►2eS�C��� <br />Printed Name and Title <br />day of Lam_, 20 I <br />Notary Public <br />�J <br />MARSHA L, BROWN <br />NOTARY PUBLIC <br />SEAL <br />STATE OF INDIANA <br />COUNTY OF ST JOSEPH <br />My Corn nission Expires June 28, 2021 <br />Version 1011712016 Contractor's Bid for Public Works - 6 <br />