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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 6th day of Sept. , 2018 <br />Subscribed and sworn to before me this 6th <br />My Commission Expires <br />6/5/22 <br />County of Residence <br />Iv, Inc. <br />7ust <br />reof Cogffractor/Bidder or Its Agent <br />n Hilarv. VP of South Bend Area <br />Printed Name and Title <br />.day of September 20_a <br />Notary Public Alisha rueger <br />St. Joseph <br />,.rrmrt»+�s�xr-'mares ° <br />ALISHA KRUEGER <br />Notary Public, state of indiana <br />St. Joseph County <br />My Commission Expires <br />y,.,,.•} . <br />t,22 <br />Jneo5,a0 <br />Version 7/20/2018 Contractor's Bid for Public Works - 6 <br />