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may result in forfeiture of contractual payments. <br />I hereby affirm under the penalties of perjury that the facts and infon-nation contained in the foregoing bid <br />for public works are true and correct, <br />Dated this 12th day of June , 2018 <br />��1,ti41E�Pi9d`� <br />a ORA TF a {� �• � <br />ate: o e _ <br />Walsh & Kelly, Inc. <br />Contractor/Bidder (FFiinn <br />Ury , <br />&aVe of Contractor/Bidder or Its Agent <br />John M. Peisker. VP of Asphalt Operations <br />Printed Narne and Title <br />Subscribed and sworn to before me this 12th day of Junp. , 201 <br />My Commission Expires 615122 <br />Notary Pub rc Alisha K eger <br />County of Residence St. Joseph <br />KRUEGER <br />�...... trrr ALISH <br />PUa{2 Notary Public. Stet' of Indla" <br />St.JasephCDUnIV <br />z *'•. *= <br />MY Commly9101) Expiry® <br />0612022 <br />June <br />Version 10117/2016 Contractor's Bid for Public Works - 6 <br />