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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 8th day of August, 2023 <br />Subscribed and sworn to before me this 8th <br />My Commission Expires 10/27/2027 <br />County of Residence <br />Selge Construction Co., Inc. <br />Contractor/Bidder (Fi ) <br />i ture of Contractor/Bidder or Its Agent <br />_Justin Butler, Vice President <br />Printed Name and Title <br />Ust , 2023 <br />�.' <br />Jln ]k 1 I, iv <br />Public <br />Berrien <br />Version 09/29/2021 Contractor's Bid for Public Works - 6 <br />rky � ' <br />Cam <br />G + caGr�r �Avs I <br />�Cot&? or <br />i S <br />