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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 25th day of July 2023 <br />Subscribed and sworn to before me this 25t <br />My Commission Expires 12/06/2030 <br />County of Residenc <br />Brown & Brown General Contractors, Inc. <br />Contractor/Bidder (Firm) <br />Signature of Contractor/Bidder or Its Agent <br />Bradley A. Romine, President <br />Printed Name and Title <br />h day of July 20 23 <br />Notary Public N 51.1 • O '; <br />-)°TgRr °G; m <br />e Elkhart = ; 3 <br />'A 0, <br />kPires 126� <br />Version 09/29/2021 Contractor's Bid for Public Works - 6 <br />