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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 8th day of August , 20_ <br />Subscribed and sworn to before me this 8th <br />My Commission Expires <br />12.14.27 <br />County of Residence <br />Omega III LLC <br />Contractor/Bidder (Firm) <br />Signature of C tractor er or Its Agent <br />Charles Gerage, General Manager <br />Printed Name and Title <br />day of August , 20 25 <br />Nota Pu <br />Cook <br />Version 07/19/2023 Contractor's Bid for Public Works - 6 <br />