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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 R� h day of /),, , 20 JO <br />Contractor/Boder (Firm.) <br />Signature of Contractor/Bid &r or Its Agent <br />Printed Name and Title <br />Subscribed and sworn to before me this day of OC l r %C -K, 20 l -O <br />My Commission Expires C311laos <br />County of Residence <br />Notary Public <br />F- w1oult <br />Heaven Edwards <br />Notary Public Seal State of Indiana <br />Elkhart County <br />Commission Number NP0725779 <br />My Commission Expires 03111/2028 <br />Version 01/29/2020 Contractor's Bid for Public Works - 6 <br />