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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 10th day of April , 2018 <br />Subscribed and sworn to before me this 10th <br />My Commission Expires 615122 <br />County of Residence <br />Walsh & Kelly, Inc. <br />Conic r/Bidder (Firm) <br />ignat e of Contractor/Bidder or Its Agent <br />John M. Peisker, VP of Asphalt Operations <br />Printed Name and Title <br />day of Aril , 2018 <br />Notary P444ic rAlish rueger <br />St. Joseph <br />„..,r <br />l illli l!/// <br />ALISHA KRUI»GER <br />tdotary Public, State of Indiana <br />i;(p L; ' _ <br />St, Joseph County <br />My Commission Expires <br />Version 10/17/2016 Contractor's Bid for Public Works - 6 <br />