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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 />NOWIIflffill, <br />e <br />d, f/NDI <br />ffflll'I <br />of Contractor/Bidder or Its Agent <br />Dustin Hilary. VP of South ITITBend ITArea <br />Printed Name and Title <br />Subscribed and sworn to before me this 26th day of t o en b r 2019 <br />My Commission Expires 6/5/22 �ITITITITITITITITITITITITIT <br />Notary Public �iisTi Krueger <br />County of Residence St. Joseph <br />ALISHA KRUEGER <br />'0 Notary Public. State of lnra� a <br />�.. <br />h N <br />St. Joseph County <br />*" <br />My Commission Expires <br />476?�+�� <br />June 05. 2022 <br />�rouo0rau <br />Version 4/2/2019 Contractor's Bid for Public Works - 6 <br />