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_ I <br /> Exhibit G <br /> C. That the Professional Service Provider is not barred from bidding on any contract as a resalt af <br /> vialation c�f 724 ILCS�133E-3 and 5l33E-4(Bid Rigging or Bid Rotating}. <br /> SECTI4N III. L7RUG FREE VVORKPLACE AND DELINQUENT ILLiNlJIS TAXES STATBMENT <br /> The undersigned states under oath that the Prafessianal Service Provider is in full cornpliance with the <br /> Illinois Drug Free Workplace Act,30 ILCS 580/1,et. seq. The undersigned also states under oath and <br /> certiftes that the Professionai Service Provider is not delinquent in payment of any taac administered by <br /> the Itlinois Department of Revenue except that the taxes far which liability for the taxes or the arnount of <br /> the taxes are being contested in accordance with the procedures established by the appropriate Revenu�e <br /> Act;or that the Prafessional Service Pravider has entered into an agreement{s)with the Iliinais <br /> Department of Revenue for the payment af all ta�ces due and is in compiiance with the agreetnent. (65 <br /> ILCS Sfl 1-42.1-1) <br /> SECTIUN IV. FAMILIARITY WITH LAWS STATEMENT <br /> The undersigned, being duly sworn,hereby states that the Professional Service Provider and its <br /> employees are familiar with and wiil comply with all Federal,S#ate and lacal laws applicable to the <br /> praject,which may include,but is nat lirnited to,the Prevailing Wage Act and the Davis-Bacon Act. <br /> PROFE I AL SERViCE PROVIDER <br /> Signature <br /> John S.Latshaw <br /> Printed Name <br /> President <br /> Title <br /> SUBSCRIBED and SWORN to before rne this ��l�day of�1,evL,�,�„- ,20 /t�. <br /> �,�^~ ��"- G.---�''� <br /> � er7n� <br /> �%' Notary Pubiic <br /> �� <br /> OFFtClAt.SEAl. <br /> J�M ALDR1p(� <br /> NOTARY PUBLIC-STATE t�ILlINOfS <br /> MY CON'�+IiSSION EXPIRES:12/16121 <br /> G-3 <br />