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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 22nd day of July 20 24 <br />Contractor_ qdder (Firm) <br />i <br />'*e of ContraetorBidder or Its Agent <br />Printed Name and Title <br />Subscribed and sworn to before me this <br />My Commission Expires A -- <br />County of Resid <br />Ailisan NICOie Nance <br />Notary Pubtie Seal Stale of In <br />Floyd County <br />F COM.ilsfon NuMbOr NP074Os33 <br />MyCa,MISS,CA Expires 412712030 <br />Version 07/19/2023 Contractor's Bid for Public Works - 6 <br />