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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 />Dated this ` day of V23 0 <br />la <br />SEAL <br />Contractor idler (Firm) <br />7 <br />S ,gna r� of ontr r/Bidder or Its Agent <br />Printed Name and Title 4�l� <br />Subscribed and sworn to before me this �,,,oav of - -(20 <br />My Commission Expires � UZ l", <br />County of Residence <br />Version 10117/2017 Contractor's Bid for Public Works - 6 <br />