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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 28th day of Nov. , 2017 <br />Subscribed and sworn to before the this 28th <br />My Commission Expires <br />9/28/2024 <br />County of Residence <br />R&R Excavating, Inc. <br />Contracto irm) <br />Signature of Con racto T r--) - <br />William Loudin, Vice President <br />Printed Name and Title <br />_ day of November 20 17 <br />'TQ.k <br />Notary Public Rebecca S . Blackston <br />St. Joseph <br />REBECCA S. BLACKSTCN <br />Notary Public, State of Indiana <br />z""SEAL- St. Josoph County <br />*� My Commission Expires <br />A ,r1','. Soptember28,2024 <br />Version 10/17/2016 Contractor's Bid for Public Works - 6 <br />