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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 11th day of April 12023 <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 11th day of April 20 23 <br />My Commission Expires <br />6/5/2030 <br />Notary Public Alisha Krueger <br />County of Residence LaPorte <br />Version 4/2/2019 Contractor's Bid for Public Works - 6 <br />