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may result in forfeiture of contractual payments. <br />M+� <br />I hereby am under fhe penalties of perjury that the facts and information contained in the foregoing bid <br />for public works are true and correct. <br />4 <br />_ <br />Dated this _ day ofjQL, , 20 a4 <br />JANEE MTOWNER <br />NOTARY PUBLIC <br />SEAL <br />ELKHART COUNTY, STATE OF INDIANA <br />MY COMMISSION EXPIRES FEBRUARY 121 <br />COMMISSION NO, 710399 <br />I'R�m�u�nCoa� tS��v�ce5,�a�_ <br />Contractor/ idder(Fim) <br />Signature o Con ractor/ dder or Its cut <br />BeC, , L. \(L5 <br />Printed Nan e and Title <br />Subscribed and sworn to before me this day <br />� of .W , 20 <br />My Commission Expires �� OAWb -A 13k NN�IIt.,— <br />No ry Public <br />County of Residence F �_� (Z� <br />Version 03/15/2024 Contractor's Bid for Public Works - 6 <br />