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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 />'I 81h 20 Iq Dated this 0) day of <br />Tkw, nrlkeA � <br />Contr#aqAidder (Firm) <br />S94ture of tontracYl3idder or Its Agent <br />Print6d Name and Title <br />Subscribed and sworn to before me this Ag'rh day of 20J-R- <br />My Commission Expires <br />Notary Public <br />PATRICINI aunty of Residence <br />" Public <br />SEAL. Jewhow", no of Indiana <br />5, 2024 <br />Version 10/17/2017 Contractor's Bid for Pubfic Works - 6 <br />