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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 ofl ovember2019 <br />Michiana Contracting Inc <br />Contractor/Bidder (Firm) <br />Signature of Contractor/Bidder or Its Agent <br />Scott Kirkpatrick, President <br />Printed Name and Title <br />Subscribed and sworn to before me this 26th day of November 12019 <br />My Commission Expires _ omU612.1 _ <br />Notary Public <br />County of Residence Marshall <br />Version 4/2/2019 Contractor's Bid for Public Works - 6 <br />