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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 13th day of Aug. 20 19 <br />Herrman & Goetz, Inc. <br />;Contractor/B0,er (Firm) <br />T tore ofttract . idder or its Agent <br />Larry Cripe, Power —of —Attorney <br />Printed Name and Title <br />Subscribed and sworn to before me this 13th day of August 120 19 <br />My Commission Expires 7/13/2022 axoti�, J&� <br />Notary Public atherine J. Gruber <br />County of Residence St. Joseph <br />Version 4/2/2019 Contractor's Bid for Public Works - 7 <br />