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violations hereunder 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 />lOth December 18 <br />Dated this day of , 20 <br />Inland Waters Pollution C ontr�'ol„ 1 �tc. <br />_ ......._ <br />l <br />rrr'liddor'l -rn) <br />e of Contractor/ actor/ � r Its Agent <br />Jamee Bedin field / Assistant Secretary <br />Printed Name and Title <br />Subscribed and sworn to before me this I oth da of Jgem 20 t <br />My Commission Expires 2 d2 I <br />Nota ublic <br />County of Residence ` Q <br />ypX',iNKMbYIN <br />MIRES <br />®LOII/1 <br />ON .10 21121 <br />co <br />Version 7/20/2018 Contractor's Bid for Public Works - 7 <br />