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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 Jul, 2018 <br />& Kelly, Inc. <br />or Its Agent <br />Dustin Hilarv. VP of South Bend Area <br />Printed Name and Title <br />Subscribed and sworn to before me this 10th day of JuIv <br />, 2018 <br />My Commission Expires 615122 <br />-e�J <br />Notary Public <br />Alisha K ueger <br />County of Residence St. Joseph <br />u+r+,n <br />SHA KF R <br />,A <br />a„ <br />Notafy <br />Public, stake <br />i <br />SLJosephLEG <br />CpYupU <br />tv <br />Expires <br />h <br />My Commission <br />5, 2022 <br />June ()5.2 <br />nrinua• <br />Version 1011712016 Contractor's Bid for Public Works - 6 <br />