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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 ']fin day of M <br />J , 201s <br />61,Jvl1k Q/ JoriCs (l3nSfWC+1olA <br />Con ractor/Bidder (Firm) <br />(t n-- <br />Sign re of Contr ctor/Bidder or Its Agent <br />/cam lc- SjUhCyi s , Plv j a-f Cqi ngc4t�- <br />Printed Name anA Title <br />Subscribed and sworn to before me this � day of 2025 <br />My Commission Expires t✓o" rixf ZOZ5 _ <br />Notary Public <br />County of Residence ('- L-w:� 3 <br />TAYLOR ELSE BURK <br />Notary Public - Notary Seat <br />STATE OF MISSOURi <br />St Louie County <br />My Commission Expires: Nov. 14, 2025 <br />Commission 0 21495267 <br />Version 1/3/2025 Contractor's Bid for Public Works - 6 <br />