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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 l l th day of June , 20 24 <br />Larson -Danielson Const. Co., Inc. <br />Contractor/Bidder (Fi ) <br />LARSON-DANIELSON <br />e <br />CONSTRUCTION CO., INC. X <br />Signature of Contractor/Bidder or Its Agent <br />Brian T. Larson, President <br />Printed Name and Title <br />Subscribed and swornto before me this 11 th day of June 920 24 <br />My Commission Expires <br />9/8/31 <br />County of Residence <br />Digilelly signed by Mi,h,1, Dzieli * <br />X Michele Dzielinski CN=—.1,EDveII�IdwneW ion,.wm", <br />Dare: 2024.06.1107:6-0600' <br />Notary Public <br />Michele C. Dzielinski <br />LaPorte <br />ELEOE6AM01IELH80 <br />`�4 M My0onm6soo Enpes <br />��... fmmvbelluWilPOU/bl3 <br />la FbYmro <br />Version 03/15/2024 Contractor's Bid for Public Works - 6 <br />