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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 --12-thday of Dec 2017 <br />Ion <br />Jack F.1131aklev, CMS Division <br />ame and "title <br />Subscribed and sworn to before me this 12thi day of December <br />7 <br />My Commission Expires 12/15/19 <br />Notary Public <br />County of Residence Hamilton <br />"0. 10 6' 6, BETH A, OONFIUQ,� <br />19 <br />otary S1016 Of lndana <br />Hanlilton Cowrity <br />Comrnissiorl N <br />MY Cwnrn,,Sk00 Exples <br />Decefter 15, 2019 <br />Version 10/17/2016 Contractor's Bid for Public Works - 6 <br />