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may result in forfeiture of contractual payments. <br />ME <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 ___ ..1.1 th day of June , 2019 <br />Subscribed and sworn to before me this <br />My Commission Expires 6/5/,22 _ w <br />Walsh 80<ek Inc. <br />`c���Its•, toe„ wdde�` l�""%l�"" <br />re of Contractor/Bidder or Its Agent <br />Dustin Hilary, VP of South Bend Area <br />Printed Name and Title <br />11 th day of „ 'roan..__....._........ 2019u <br />Notary iic Alish r6 er- <br />County of Residence St. Jose h ....... <br />d"&�^ <br />ALI <br />P biA. <br />0, <br />stateECER <br />Notary of Indiana <br />Si:I <br />3t. Jos®ph County <br />'•,„ �' <br />�010 �w <br />My Commission Expires <br />., <br />FSItl,4awr <br />�,., 2022 <br />Juno 0.�, <br />Version 4/2/2019 Contractor's Bid for Public Works - 6 <br />