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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 11,.th day of AUS.................1 2020 <br />Inc. <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 11ah....... day of u5ust.. , 20 20 <br />M Commission Expires 6/5/22 <br />Y.. .; ...:.:.. <br />Notary Public Alifpza Krueger mN <br />County of Residence St. Joseph <br />4C 4 H KRI.iEGER �r <br />Contractor's Bid for Public Works - 6 <br />,iVtf lift�f ,} <br />pubVic, state of {nJixna� <br />�F <br />�. -a e k <br />.ICtSB�'Yt�:aUkiTW <br />F .pir <br />�,y Crymrriis rJrt s�s <br />d <br />Version 4/2/2019 <br />