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may result in forfeiture of contractual payments. <br />MM <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 />h <br />Dated this day of A\J , 2019 <br />JANEE M TOWNER <br />NOTARY PUBLIC <br />SEAL <br />ELKHART COUNTY, STATE OF INDIANA <br />MY COMMISSION EXPIRES FEBRUARY 12, 2026 <br />COMMISSION NO.710399 <br />lam l urn N(Z <br />C ntractor/l idde' (Firm) <br />Haig ;�,ttu�re of �s�a,ttp �actor�'l'��ralder or Its Agent <br />Printed Name and Title <br />Subscribed and sworn to before me this 1 day of Iq _ , 20, 19 <br />My Commission Expires cla <br />jj:klaox, ......... ...... __...................................._....� <br />No ry Public <br />County of Residence .K n <br />Version 1/17/2019 Contractor's Bid for Public Works - 6 <br />