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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. J <br />I <br />Dated this day of U 20;5' __UU <br />Signature of Contractor/Bidder ofIts Agent <br />&4 ZS �� <br />Printed Name and Title <br />Subscribed and sworn to before me this 2204 day of T%A1 1 .20 2S <br />My Commission Expires It - 21 - WS <br />County of Residence <br />golra--ry Public <br />1�-1 K-A-) 1(�- <br />E,4 <br />ES BRAATZ <br />Public - Seal <br />ty State of IndianaNumber MP0752954 Expires Nov 21, 2031 <br />Version 1/3/2025 Contractor's Bid for Public Works - 6 <br />