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<br /> <br />Version 08/25/2021 Contractor’s Bid for Public Works - 6 <br />may result in forfeiture of contractual payments. <br />*** <br /> <br /> <br /> <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 /> <br />Dated this day of , 20__ <br /> <br /> <br /> Contractor/Bidder (Firm) <br /> <br /> <br /> Signature of Contractor/Bidder or Its Agent <br /> <br /> <br /> Printed Name and Title <br /> <br /> <br /> <br /> Subscribed and sworn to before me this day of , 20 <br /> <br />My Commission Expires <br /> Notary Public <br /> <br /> County of Residence <br />22nd October 21 <br />R. Yoder Construction, Inc. <br />Jason Yoder, President <br />22nd October 21 <br />March 30, 2024 Shelly J. Brigham <br />Kosciusko <br />R. Yoder Construction, Inc.