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may result in forfeiture of contractual payments. <br />3M <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 13th� ww day of August, 2019 <br />A <br />PAM <br />idder or Its Agent <br />Miutln Hilary, VP of South Bend Area <br />Printed Name and Title <br />Subscribed and sworn to before me this 13th day of ...... 6 ust 2019 <br />_s e <br />My Commission Expires 6/5/22 � � <br />Notary )HC Alisha Kruecger <br />County of Residence Stµµ Jwoseph <br />P,LiSHA KRUEGER <br />r ,Notary <br />Public, State of fndiafM <br />�LAL `" <br />st.Josephcounty <br />mm <br />My Commission Expules <br />June05, 2022 <br />Version 4/2/2019 Contractor's Bid for Public Works - 7 <br />