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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 25th day of October, 2022 <br />`%%N tfactors <br />�,,....,,.,.�r0�°i <br />. VORATE %Ss <br />e 'ii •, . s <br />'soo11B bN d l�` <br />Subscribed and sworn to before me this 25th <br />My Commission Expires 6/5/2030 <br />County of Residence <br />'in-tractor/Bidder or Its Agent <br />Dustin P. Hilary, Director of Estimatinnq <br />Printed Name and Title <br />day of Oc ober 12022 <br />- LjoeL� 0 �?�z <br />V11 <br />Notary Public Ali n <br />a Krueger <br />LaPorte <br />S►R'P�a <br />AUSHAKRUEGER <br />X4;s <br />My Commission Expfes <br />__ SEAL * <br />June 5, 2030 <br />` <br />Commission Number NP0653544 <br />U Pate County <br />Version 09/29/2021 Contractor's Bid for Public Works - 6 <br />