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violations hereunder 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 25th day of April _, 20 17_ <br />(F <br />of Cont6actor/Bidder or Its Agent <br />Printed Name and Title <br />Subscribed and sworn to before me this 25th day of April , 2017 <br />My Commission Expires 6/5/22 <br />Notary Public/Alisha Krueger <br />County of Residence St. Joseph <br />Version 10/17/2016 Contractor's Bid for Public Works - 6 <br />