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may result in forfeiture of contracnial 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 __j day of 20 C� _L <br />Contractor/Bidder f <br />Signature of or its Agent <br />hl /lay' <br />. ......... . .... Printed Name and Title <br />Subscribed and sworn to before me this day of 3,01 1,,",1 2017- <br />My Commission Expires _3 h <br />County of Residence . ... . . . ........ . .... . .... .. . . .... <br />MATTHEW BAKER <br />NOTARY PUBLIC - STATE OF MICHIGAN <br />COUNTY OF KALAMAZOO <br />My Commission Expires 03/05/2025 <br />Acting in the County of , 11A -;�qO <br />Version 7/20/2018 Contractor's Bid for Public Works - 7 <br />