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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 12th day of June , 20 18 <br />Subscribed and sworn to before me this 1 2th <br />My Commission Expires 3/112019 <br />County of Residence <br />Brown & Brown General Contractors, Inc. <br />Contractor/Bidder (Firm) --I <br />6 bnl�� <br />Signature of Contractor/Bidder or Its Agent <br />Eric Brown, President <br />Printed Name and Title <br />day of June —,20 18 <br />Notary Pub ric' <br />St. Joseph Co, IN rnSEAL: <br />01: 1�49 <br />'1111111110" <br />Version 10/17/2017 Contractor's Bid for Pubfic Works - 7 <br />