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+ may result in forfeiture ofaontractual payments. <br />I hereby affirm under the penalties of perjury that the facts and information contained n,the,foregoing bid <br />for public works are true and correct. <br />Dated this day of _ �c 201F <br />r <br />� m ���g pJ Contractor�I iclder ;»1� <br />I SEAL Sig ire of Contr ctor/bidder or Its Agent <br />NN 1'rtn ecl Name and Title <br />Subscribed and sworn to before me this 3 day of 1, 20 <br />My Commission Expires -7� <br />No ary Public <br />County of Residence <br />Version 7/20/2018 Contractors Bid for Public Works - 6 <br />