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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 13th day of October, 20 20 <br />Subscribed and sworn to before me this 13th <br />My Commission Expires August 1, 2022 <br />County of Residence <br />Berglund Construction Com <br />Contractor/Bidder (Firm) <br />Signature of Contractor/Bidder or Its Agent <br />Jack Tribbia. President - Restoration <br />Printed Name and Title <br />day of October , 20 20 <br />41*-kL1111&1�-1A&--- <br />Notary Public <br />Will <br />"OFFICIAL SEAr <br />,+�PRIL F AN' KLIN W22 <br />W <br />Notary Pt Glic" tail of <br />My omr a+r�SaA'" Excifts "mAu M ii"i0" No. 079 <br />Version 4/2/2019 Contractor's Bid for Public Works - 6 <br />