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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 November, 2019 <br />Printed Name and Title <br />Subscribed and sworn to before me this z b dayM N tlde-• 2019 <br />My Commission Expires 1 a 1(6 ()L `( <br />Notary Public <br />County of Residence S � k <br />p & VAN N LJI <br />. Sm.rr . . <br />Notary P'ubltc <br />SP. ,lrasoO County, Slato of Indus <br />y <br />L uoote,�d ursrn 4'Wfe$ DO 182fi24 <br />Version 4/2/2019 Contractor's Bid for Public Works - 6 <br />