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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 />4,0 <br />Dated this%_-_ �'_ day of PC's 20 Z <br />C&S Masonry Restoration LLC <br />Contractor/Bidder (Firm) <br />Signature of Contractor/Bidder or Its Agent <br />Steve Fields President <br />Printed Name and Title <br />Subscribed and sworn to before me this, r <br />fir'..day of C�vr. <br />My Commission Expires 3 • �' <br />Notary Public <br />County of Residence <br />PAMELA A. SHIDAKER <br />NOTARY PUBLIC <br />SEAL <br />ST JOSEPH COUNTY, STATE OF INDIANA <br />COMMISSION NO. NP0732251 <br />MY COMMISSION EXPIRES MARCH 8, 2029 <br />Version 09/29/2021 <br />Contractor's Bid for Public Works - 6 <br />