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violations hereunder 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 10th............. day of Dec. , 2019 <br />Coll <br />s <br />V,? RA tF <br />' <br />,gr <br />SEAL <br />Kell <br />fs Agent <br />nw Hilary, VP of South Bend <br />Name and Title <br />Subscribed and sworn to before me this 10th day of December 2019 <br />My Commission Expires.- 0/5/22 <br />Notary Puh'i� Alisha Orueger <br />County of Residence _W ........... <br />ALISHA KRUEGER <br />�1Y PJ ° <br />Notary Public, state of Indiaar <br />py� ` <br />St. Joseph County <br />My commission Expires <br />r" <br />JUnF 05, 2022 <br />W <br />Version 1/17/2019 Contractor's Bid for Public Works - 6 <br />