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Version 09/29/2021 Contractor’s Bid for Public Work - 6 <br />may result in forfeiture of contractual payments. <br />*** <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 day of , 20__ <br /> <br />Contractor/Bidder (Firm) <br />Signature of Contractor/Bidder or Its Agent <br /> <br />Printed Name and Title <br />Subscribed and sworn to before me this day of , 20 <br />My Commission Expires <br />Notary Public <br />County of Residence <br />26th Sept.23 <br />Browning Chapman, LLC <br />President <br />25th September 23 <br />August 22, 2024 <br />Madison