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may result in forfeiture of contractual payments. <br />I hereby affirm under the penalties of pefjury that the facts and information contained in the foregoing bid <br />for public works are true and correct. <br />Dated this I9 _ day of 6 , 20_0 <br />WE <br />Sig lure of Contractor/B' lder or Its Agent <br />All <br />/A..�� <br />Print d Name and lit e <br />Subscribed and sworn to before me this-,)/J- / day of )C- / „ 20 IP <br />My Commission Expires /1a2/zjy <br />County of Residence <br />Notary PARC <br />.� <br />HARRY P SINGLETON <br />Notary Public, State of Indiana <br />St. Joseph County <br />Commission # 678559 <br />My Commission Expires <br />January 21, 2024 <br />Version 7/20/2018 Contractor's Bid for Public Works - 6 <br />