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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 / ;; 1�\ day of z&. -d , 20a, <br />Contract GB' (F- j <br />Signature of Contractor/Bidder r Its Agent <br />Printed Name and Title <br />Subscribed and sworn to before me this 13 day of P' 1 , 20 d U <br />My Commission Expires a� tb o a(n ?AJk)OJ-t" <br />Notary Public <br />County of Residence el aaA <br />ENotofy <br />=County <br />s <br />of Indiana07267793/11r 028 <br />Version 01/13/2021 Contractor's Bid for Public Works - 6 <br />