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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 .._._..10th.. day 6iecember, 20 9 <br />Selge Construction Co., Inc. <br />.................... ..............�.�... <br />Contractor/BidderFirm <br />Signature of Contractor/Bidder or Its Agent <br />Robert Kuhns, Project Engineer <br />Printed Name and Title <br />Subscribed and sworn to before me this 10th day of December „ , 2019 <br />My Commission Expires 07 25 2020 tt <br />_ITITITITIT <br />Notary Public <br />County of Residence Berrien _ �u��wwrr, <br />PUBLIC <br />03a MY COMMISSION z Z <br />\ EXPIRES <br />"• 7 25 2020�� <br />��">"�6rWrrmr6 <br />i0 <br />aw"�� <br />Version 1/17/2019 Contractor's Bid for Public Works - 6 <br />