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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 25th <br />My Commission Expires March 30, 2024 <br />R. Yoder Construction, Inc. <br />Contractor/Bidder (Firm) <br />Signature of Contractor/Bidder or Its Agent <br />Jason Yoder, President <br />Printed Name and Title <br />day of July 92023 <br />Notary Public Shelly J. righam <br />County of Residence Kosciusko <br />Version 09/29/2021 Contractors Bid for Public Works - 6 <br />