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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 26th day of Nov. , 2019 <br />Ili <br />idder or Its Agent <br />Dustin Hilary, VP of South Bend Area <br />Printed Name and Title <br />Subscribed and sworn to before me this 26th day of. November ...... 20119 <br />My Commission Expires mmITIT6/5/22mmmmmmm .„ <br />..._ .__. <br />Notary Ic Alish Krueger <br />County of Residence St. Joseph <br />ALISHA KRUEGER <br />'r,b � public, State of Indiana <br />, Notary <br />LI" <br />St. Joseph County <br />My commission Expires <br />June O 5, 2022 <br />Aftl I81zW4bk <br />M1 <br />Version 4/2/2019 Contractor's Bid for Public Works - 6 <br />