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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 26th day of Sept. , 20 23 <br />Subscribed and sworn to before me this 25th <br />My Commission Expires August 22, 2024 <br />County of Residence <br />Browning Chapman, LLC <br />Co ctor/Bi (Firm) <br />Signature of Contractor/Bidc <br />J4 or Its Agent <br />President <br />Printed Name and Title <br />day eptemb 12023 <br />Notary Public <br />Madison <br />PETER JAMES LYON . <br />NOTARY PUBLIC <br />SEAL <br />MADISON COUNTY, STATE OF INDIANA <br />MY COMMISSION EXPIRES AUGUST 22, 2024 <br />Version 09/29/2021 Contractor's Bid for Public Work - 6 <br />