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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 st day of March , 20 22 <br />Bit -Mat Products of Indiana <br />Co c#orBidder (Firm) <br />Si Lure of Contractor/Bidder WIN Agent <br />John Baumgartner, General Manager <br />Printed Name and Title <br />Subscribed and sworn to before me this 21st day of , 20?9 <br />My Commission Expires Nov 1, 2024 <br />N tary Public i berly Smith <br />10mberly Smhh <br />County of Residence Dekalb Hotwy Public, State of lndlana <br />County of DeSEALKalb E <br />My Commission Expires- 1�0 �.aq <br />Version 09/29/2021 Contractor's Bid for Public Works - 6 <br />