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iy <br />n. <br />'s <br />'s <br />)f <br />:o <br />in <br />n, <br />;s <br />Is <br />,n <br />Y <br />)r <br />s, <br />,c, <br />)r <br />may result in forfeiture of contractual payments. *** <br />111creby 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 ..... day of 20J <br />wa <br />Sir attar o Contactor/'idder or Its Agent <br />Printed Name and Title <br />y Subscribed and sworn to before me this day of, <br />:c <br />_ . <br />s My Commission Expires �,_ <br />Notary Public <br />.e <br />;t <br />a <br />n <br />h <br />it <br />e <br />:s <br />Version 7/20/2018 <br />County of Residence <br />Contractor's Bid for Public Works - 6 <br />20 <br />