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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. cel N� _ day of I l « , 20,'a,)_ <br />97 <br />C-11-4 Ea, -,(A <br />Contractor/ �Jid (Firm) <br />St'g�n%ature/of Contractor/Bidder o s Agent <br />Printed Name and Title <br />�-h 1 n <br />Subscribed and sworn to before me this day of I'� lW, 20L <br />My Commission Expires 41� U)MM4) <br />Notary Public { Q <br />County of Residence 4&VtR �dw0�lr� <br />Heaven Edwards t <br />Notary Public Seal Stale of Indiana �? <br />Elkhart County yy <br />Commission Number NP0725779 t <br />My Commission Expires 03111/2028 <br />Version 01/13/2021 Contractor's Bid for Public Works - 6 <br />