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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 26th day of March , 2019 <br />Subscribed and sworn to before me this 26th <br />My Commission Expires January 27, 2023 — <br />Beaty Construction, Inc. <br />1I Contractor/B1 ( (Firm) irm e d I <br />Sig ire of —Contractor/Bidder or Its Agent <br />Daniel S. Beaty, President <br />Printed Name and Title <br />of _March —12019 <br />Notary Public Shannon E. Fogle <br />County of Residence Shel <br />Version 1/17/2019 Contractor's Bid for Public Works - 6 <br />