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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 20th day of5ppteq114W— 18 <br />Subscribed and sworn to before me this <br />My Commission Expires n7.j25.jqn20 <br />Selge Construction Co., Inc. <br />Contractor/Bidder (Firm) <br />Signature of Contractor/Bidder or Its Agent <br />Robert Kuhns, Project Engineer <br />Printed Name and Title <br />20th day of September— )1 18 <br />-Y 4Noary Public <br />County of Residence Berrien <br />Ry%, <br />I Pt, B U C <br />MY G G1 U IV! K"-, " j(,,N <br />7,2' UO <br />Av......... <br />CO <br />Version 10/17/2017 Contractor's Bid for Public Works - 6 <br />