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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 ................ . . — ::� day of-- 20 NI\ <br />Subscribed and sworn to before me this <br />My Commission Expires T - '�" <br />County of Residence <br />Contractor/Bidder (Firm) <br />n. <br />Signature of Contractor/Bidder or Its Agent <br />Printed Name and Title <br />day of 20 <br />\ON e,- <br />Notary Public <br />6-0-tos �rvubltc, S1 ate 01,wo" <br />County of AlIeWW <br />#Sy rofnrinission E xpirft 08- <br />A40100 1110 IhG G0100111 a$ <br />Version 7/20/2018 Contractor's Bid for Public Works - 6 <br />. .............. - <br />