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violations hereunder 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 1 Oth <br />A ay of Deceml�Q020?^ <br />Subscribed and sworn to before me this <br />My Commission Expires <br />08/05/2031 <br />Nick Gurbick, Vice President <br />Printed Name and Title <br />of December 20 24 <br />County of Residence St. <br />Public ]uli Hodowaniec <br />JLJL� H000wANiEC <br />St Josef CounPublic <br />- Sta Seal <br />Comn1fssion Number NpO6j1289a <br />MY Camn,fssion ExRfres Aug g, 2Q;1 <br />Version 07/19/2023 Contractor's Bid for Public Works - 7 <br />