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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 12th day of August, 2019 <br />COLGLAZIER <br />,:::-s <br />State of tntllana25 <br />°; <br />Ell, <br />County <br />�on <br />0 703895wssion <br />Expires <br />10, 0 <br />Coreslab Structures (Indianapolis) Inc.. <br />..... <br />Contractor/Bi er (Firm) <br />Signature of C.cintrac orlBidder or Its Agent <br />Mr. Corey Greika, Vice President/ Sales Manager <br />Subscribed and sworn to before me this 12th <br />My Commission Expires <br />County of Residence <br />Printed Name and Title <br />day of ...........August __, 20_19 <br />w, <br />Nota Public <br />Version 1/17/2019 Contractor's Bid for Public Works - 7 <br />