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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 dayof`— ,201c� <br />:Con�tractoFimi) � <br />r/Bidder <br />Signature of C"ontr`ictor/B'idder or Its Agent <br />v/ze",- w)ae+ OtM®Y <br />Printed Name and Title <br />Subscribed and sworn to before me this day of :YkAugrl 20 17 <br />g <br />My Commission Expires 5&s <br />Nota4V1, <br />County of Residence r414A-q z °® <br />MATTHEW BAKER <br />NOTARY PUBLIC - STATE OF MICHIGAN <br />COUNTY OF KALAMAZOO <br />My Commission Expires 03/0512025 <br />Acting in the County of WAkA411ad <br />f9 <br />b- <br />Version 7/20/2018 Contractor's Bid for Public Works - 7 <br />