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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 13th day of Dec. , 2022 <br />11�o�tr a c''� <br />to <br />`�pRPORgTF <br />�'• SEA <br />A. <br />of Contractor/Bidder or Its Agent <br />'Dustin P. Hilary, Director of Estimating <br />Printed Name and Title <br />Subscribed and sworn to before me this 13th day of December , 2022 <br />My Commission Expires 6/5/2030 <br />Not ublic Alisl� Krueger <br />County of Residence <br />LaPorte <br />ALISHA KRUEGER <br />o� iY P(jB4, <br />My Com Expires <br />JuneCarm*A5NP0653544 <br />La Pate County <br />Version 09/29/2021 Contractor's Bid for Public Works - 6 <br />