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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 />Dated this 21 5-7( day of <re -4, 20 22 <br />Con actor/Bidder (Firm) <br />Signature of Contractor idder or Its Agent <br />Printed Name and Title <br />Subscribed and sworn to before me this 2 / s�day of A«3 r"c-"" 20 -?Z <br />My Commission Expires _C%CZr?, Zoor <br />County of Residence <br />Notary Public <br />a" 0 C, <br />BRAY SLI EF R <br />;SEAL * TOWN Cw",so Of Iro +a <br />,Ncir,N� Codon EVW JK 1Z 2029 <br />COMM" NumUer. omm <br />Version 09/29/2021 Contractor's Bid for Public Works - 6 <br />