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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 22nd day of Tanua , 2019 <br />Midland 1-7,rwyinevringo Company— Inc. <br />Contractor/Bidder (Firm) <br />Signature of Contractor/Bidder or Its Agent <br />g g <br />_Michael . W. Frahn CPA lire+s <br />-id aIa —C, l^ <br />Printed Name and Title <br />Subscribed and sworn to before me this 22nd day of gnuary __„ 20 19 <br />My Commission Expires _ 6 27919www Be �� �. Aj c l rt, r __. � <br />Notary Public <br />County of Residence St. os eh. <br />Version 7/20/2018 Contractor's Bid for Public Works - 7 <br />