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may result in forfeiture of contractual payments. <br />I hereby affirin 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 Aa (0 20f% <br />day ofi4t—z' <br />JAREE M TOWNER <br />NOTARY PUBLIC <br />M. <br />SEAL <br />ELKHART COUNTY, STATE OF INDIANA <br />f�wm I U <br />Contractor/Bid (Finn) <br />S?KatLu'e of Contractor/Bidder or Its Agent <br />MAX 8KEq <br />Printed Name and Title <br />Subscribed and sworn to before me this ot 01, day of J'd M'G� '20 1W, <br />My Commission Expires <br />County of Residence <br />K(gary Public <br />■ <br />Version 10/17/2017 Contractor's Bid for Public Works - 6 <br />