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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 eorrect. <br />Dated this ^28th_ day of Nov 2017 <br />John Boettcher Sewer & Fxcavating Contractor <br />ContiractWBidderr <br />ignatu of Contractor/Bid r s nt <br />JoY�n Boettcher, President <br />Printed Name and Title <br />Subscribed and sworn to before me this 28th day of November 20 17 <br />My Commission Expires May 9, 2024 <br />Notary Public Eii ' A, Leonard <br />County of Residence St. Joseph <br />uu41r+a <br />t o��q, ELlC'iA A LEONARD. <br />0 Notary Public Stata di Indiana <br />m#;.--:---.*a Cammissiati M 684889:'. <br />SiA4,: C - <br />is , My .r..Sif mission Expires <br />'•.,"tiniA;r*,.�` spy 09' 2024 <br />v NIlU141P <br />{ <br />Version 10/17/2016 Contractor's.Bid for Public Works • 6 <br />