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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 day of NI,4f 202-3 <br />Contract 1 ler Fi <br />Signature of Contractor/Bidde r Its Agent <br />Printed Name and Title <br />Subscribed and sworn to before me this day of lc: , 20�;O <br />My Commission Expires " c%' < c1 F ati 1w—L oL9i L\�� <br />Notary Public <br />County of Residence`' <br />ROXANNE LAURENE ALFORD <br />;��o P •Gee'' Notary Public, State of Indiana <br />= .:SEALE St. Joseph County <br />i • ;'+ <br />.: ; Commission Number NP0741524 <br />My Commission <br />203xpires <br />Version 09/29/2021 Contractor's Bid for Public Works - 6 <br />