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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 2!!�..................... _, day of 4)W`, 20A <br />6," Coa�actorlLdder(Firm) <br />of rntracto"r'/B <br />idder or Its Agent <br />Subscribed and sworn to before me this f 2"6l <br />My Commission Expires _ 21212r� <br />County of Residence <br />Printed Name and Title <br />day of A«It ._, 20Iq <br />Notary Public <br />KL�LLY M HAIN1D,AR5,,H <br />ryea,r�". <br />Ne�Prom� �"tr6rPer SiCatc, arf P��Gborana <br />ST )d as �;'B I'I G"CY t➢I"'YTy^ <br />'. k M ." <br />Q, <br />Y fry <br />'�'��'4ll PM�Mtlw �9y <br />471YY1 7P 1F:el C.1 r9 �..hFBlftl. y; <br />rl)bruary 02q <br />2020 <br />Version 1/17/2019 Contractor's Bid for Public Works - 6 <br />