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may result in forfeiture of contractual payments. <br />I hereby affirm ender the penalties of perjury that the facts and information contained iii the foregoing bid <br />for public Nvorks are true and correct. <br />Dated this )—// day of Y& Y , 20/X <br />�w,,,,, <br />LINDA J GIL]Indiana <br />t,u, <br />a �PPY• A�� `. Notary <br />Puw1c, state <br />St. Joseph COucommission <br /># 62My <br />CiOMM salon EAugust31,2 <br />Printed Name and Title <br />Subscribed and sworn to before me this day of ��.L��, 20- <br />My Commission Expires r� � t�� Wall r <br />Notary Public <br />Version 10/17/2017 <br />Count`• of Residence d DU' M <br />Contractor's Bid for Public Works - 32 <br />