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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 23rd day of . May , 20 23 <br />`��ttttiiil/i�i <br />`CNN \ �L(actors <br />o; L�E�Q0RArF <br />SEA <br />4f41,11111s>0 <br />M <br />Inc. <br />inn <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 23rd day of Mav 20 23 <br />My Commission Expires 6/5/2030 1 ' iL� <br />Notary Pu 1,ic Alisha Kru r <br />County of Residence LaPorte <br />ALISHA FUEGER <br />MYCommissionExpites <br />=* SEAL *` <br />June 5,2030 <br />Commission Number NPW53544 <br />La Porte County <br />Version 09/29/2021 Contractor's Bid for Public Works - 6 <br />