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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 />Datedthis 13th dayofOctobeO20 <br />Larson Danielson Const.; Co. Inc. <br />Contractor/Bidder (Firm) <br />LARSON DANIELSON -� <br />sir ' x <br />CONSTRUCTION CO., INC, l .,.. <br />A� Signature of Contractor/Bidder or Its Agent <br />Timothy F . Larson, President <br />Printed Name and Title <br />Subscribed and sworn to before me this 13th day of October 2020 <br />My Commission Expires 9 / 8 / 2 0 —j.. <br />Notary Public <br />Michele C. Dzielnski` <br />County of Residence LaPorte <br />U FDA#. <br />� <br />Version 4/2/2019 Contractor's' Bid for Public Works -<6 <br />