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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 12th day of Sept. , 2023 <br />NN��ontr a c'to IIJfs,f���i <br />a; �pR40RgjF :.� <br />SEAL..-*!*, <br />����i�o�e Nbl oN` �����• <br />Subscribed and sworn to before me this 12th <br />My Commission Expires <br />6/5/2030 <br />County of Residence <br />ff <br />of Contractor/Bidder or Its Agent <br />Dustin P. Hilary, Director of Estimating <br />Printed Name and Title <br />day of Se to ber , 20 23 <br />r J-1k, , <br />Notary c Alisha r ger <br />LaPorte <br />...... c;� <br />ALISHA I(RUEGER <br />W Commission ExpQes <br />: <br />_* SEAL • <br />June 5, 2030 <br />Number NP0653544 <br />commission <br />La Porte County <br />Version 09/29/2021 Contractor's Bid for Public Works - 6 <br />