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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 />,�ttirll�i, <br />`•`''Contra, <br />Dated this I lth day ofNovember 2025 <br />Michiana Contracting Inc ; •c : &PoAFF <br />Contractor/Bidder (Firm) — <br />SEAL <br />Signature of o ractorlBidder or Its`Ageny� .d.ana \� <br />111,11110,\ <br />Scott Kirkpatrick, President <br />Printed Name and Title <br />Subscribed and sworn to before me this 1 lth <br />My Commission Expires 06/12/27 <br />County of Residence <br />day lo�f, hNovember 2025 <br />Notary Public <br />Marshall <br />LISA SOTTO <br />Notary Public - Seal <br />Marshall County - State of Indiana <br />Commission Number NP0720753 <br />My Commission Expires Jun 12, 2027 <br />Version 1/3/2025 Contractor's Bid for Public Works - 6 <br />