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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 , day of, 20451— <br />-�ndi ana A64 4 /y <br />Contractor/Bidder Fin <br />Signature of Contractor/Bidder QVIts Agent <br />Printed Name and Title <br />Subscribed and sworn to before me this ds day of 20_2-6' <br />My Commission Expires <br />Notary Pppublic\\ <br />County of Residence <br />` ; <br />AOXAIdNE LAJREidF 11LFORl1 k <br />' '• <br />Notary Public, Stai0 of Indiana <br />�- "SEAL.- ` = <br />"SEAL <br />St. Joseph County <br />o- <br />Commission Numbor NP0741524 <br />" <br />My Commission Expires <br />May3?,2030 <br />Version 5/20/2024 Contractor's Bid for Public Works - 6 <br />