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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 ITITmmm _ day of, 20 <br />Subscribed and sworn to before me this �S <br />�-w <br />My Commission Expires Y yo"2__ <br />County of Residence <br />Woodcox Building Contractor, Inc. <br />Contracto adder (Firm) <br />Signature of ContractorMidder or Its Agent <br />Adam George President <br />Printed Name and Title <br />day of .20 0 <br />Notary Public <br />IWlIy1IUNA &."101 Il VI�1:, <br />I'''l� ur mO f l IIV�Ih ,'irlk y�m��u iili y, IIN u a' x <br />fUly^°~piwxlah� f18/20`"" <br />r, <br />Version 8/16/2018 Special Provisions - 6 <br />