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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 tfiis — A -A— day of f , 20 <br />� 11111�s�trJJ �1r% I4na E -r <br />�19 ,ot1ltC"auto Cie' I'I' <br />SEAI- Signature of Contractor/Bidde or Its Agent <br />Printed Name and Title <br />Subscribed and sworn to before me this day of Ac 20_... <br />My Commission ExpiresAA� 0 <br />ItcAary Public <br />6,- <br />County of Residence w - z m <br />Version 4/2/2019 Contractor's Bid for Public Works - 6 <br />