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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 18th day of April, 2019 <br />LARSON DANIELSON <br />sEnt CONSTRUCTION CO,, INC, <br />Larson Danielson <br />Construction Company, Inc, <br />Contractor/Bidder (Firm) <br />X <br />k :L-0.1 -z A.", <br />Signature of Contractor/Bidder or Its Agent <br />Timothy F. Larson, President <br />Printed Name and Title <br />Subscribed and sworn to before me this 18th day of <br />My Commission Expires <br />9/8/23 <br />County of Residence <br />April �2019 <br />X <br />Notary Public Michele -."y Dzielinski <br />LaPorte <br />mM+ MICHELE CECELIA DZIELINSKI <br />' = La Porte County <br />„yews My Commission Expires <br />September 9, 2023 <br />Version 1/17/2019 Contractor's Bid for Public Works - 53 <br />