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may result in forfeiture of contractual payrnents. <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 L2th day of June 20 18 <br />--- — — <br />0 <br />NO "I'll, <br />0 <br />0 C)V R4rj-.. 6 1 <br />C) <br />SEAL 6 <br />V. <br />Subscribed and sworn to before me this 12th <br />My Commission Expires March 1, 2020 <br />County of Residence <br />Ziolkowski Construction, Inc. <br />Contractor/Bidder (Firm) <br />f j <br />Signature of Contractor/Bidder or Its Agent <br />Bill Favors, President <br />Printed Name and Title <br />day of June , 20 18 <br />-xxc <br />Notary Public Shannon Reidenbach <br />St Joseph <br />SHANNON REIDENBACH <br />' I I <br />Notary Public- Seat <br />State of Indiana <br />Ply <br />C,)m I xPj r, <br />y Cornnnission Fxpires Mar 1, 2020 <br />Version 10/17/2017 Contractor's Bid for Puiblic Works - 7 <br />