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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 �0"' day of Or-W , 2011 <br />t � o���tra or�l3idde� <br />Signature of C0 <br />ntractoi:)'l3idder Its Agent <br />a <br />.m .................... �..... <br />Printed Name and Title <br />Subscribed and sworn to before me this 2-lay of 20 _9 <br />My Commission Expires <br />Notary Public <br />County of Residence <br />Version 4/2/2019 Contractor's Bid for Public Works - 6 <br />