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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 2020 <br />ffj <br />of Contractor/Bidder 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 May .,2020 <br />My Commission Expires 6/5/22 -- --------- - <br />Note Tac A i ha Krueger <br />I 0,F I <br />County of Residence St. Joseph <br />uPiuis <br />ALISHA KRUEGER <br />Notary <br />Public, State of Indiana <br />st, Joseph County <br />My commission Expire, s <br />JuneO6,2022 <br />Version 4/2/2019 Contractor's Bid for Public Works - 6 <br />