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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 11th day of December. 201-1 <br />\ot11111t111/1j11, <br />$�lbscribed and sworn to before me this 11th <br />s t +$m' �y (i ission Expires / V9 <br />PVC �+ f Co. <br />�xo` �Q,' <br />County of Residence <br />Pullman SSA'. In <br />SignaVrc of Contia/orBidder or Its Agent <br />J. P6te Wallace Or. Branch Director/ Asst. <br />Printed Name and "Title <br />day of December , 2017 <br />Nota Public <br />00JAII <br />Version 10/17/2016 Contractor's Bid for Public Works - 6 <br />