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may result in forfeiture of contractual payments. <br />13M <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 24th — day of August-, 20 21 <br />Subscribed and sworn to before me this <br />My Commission Expires 03/06/2024 <br />!1111111 ililml <br />Co ct F* <br />Signature of Contractor/Bid&NZ6r Its Agent <br />Matthew D. Cain, President <br />Printed Name and Title <br />24th day of August —120 21 <br />Nota Public Cynthia L. Vanheste <br />County of Residence <br />do= <br />ANAM <br />Version 08/16/2021 Contractor's Bid for Public Works - 6 <br />