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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 dayofecembeA 24 <br />Larson -Danielson Const. Co., Inc. <br />Contractor/BiddeW,�� <br />) <br />CONSTRUCTION CO., INC. <br />X A,_ <br />Signature of Contractor/Bidder or Its Agent <br />Brian T. Larson, President <br />Printed Name and Title <br />Subscribed and sworn to before me this 12th day of December 2024 <br />Ily g E b Micbela Dzielinski <br />US E- y @IEconstrucYan..wm'. CN=Micbele <br />My Commission Expires 9 / 8 / 31 X Michele Dzielins i�= ;ZQ24121007 140006- <br />NotaryPublic Michele C. Dzielinski <br />County of Residence <br />LaPorte <br />Version 09/29/2024 Contractor's Bid for Public Works - 6 <br />