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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 9th day of May 20 23 <br />Subscribed and sworn to before me this 9th <br />My Commission Expires d e 4 iG q� L( <br />County of Residence <br />The Robert Henry Corporation <br />Contr tor/Didde (Firm) <br />Signature of Contrac r/Bidder or Its Agent <br />Brian S. Henry, President <br />Printed Name and Title <br />day of Ma 20 23 <br />Notary Public <br />P& VAN NUSSBAUM <br />SEAL Notary Public <br />* St. Joseph County, State of Indiana <br />�---- Commission Expires Oct. 16, 2C77 <br />Version 09/29/2021 Contractor's Bid for Public Works - 6 <br />