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may result in forfeiture of contractual payments. <br />t <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 12th day of August, 201 9 <br />�)BLIC <br />d <br />rya <br />2.. <br />Subscribed ankgw6, ` N <br />110 <br />My Commission Expires � <br />latile Roofing and Sheet Met l a V C. <br />Contractor/Bidder n) <br />rtttrw°e of Conn` ct;or Ii ¢ler is Agent <br />Gerald Lon 'erot - President <br />Printed Name and Title <br />Public <br />County of Residence _Elkhart <br />Version 412 2019 Contractors Bid for Public Works - 7 <br />