Laserfiche WebLink
Exhibit G <br /> The corporate officers are as follows: <br /> President: rt t / (/t.1• ��!� <br /> Vice President: IC W t�j t� <br /> Secretary: Wn�tzt <br /> C. PARTNERSHIP OR LLC <br /> The partners or members are as follows: (Attach additional sheets if necessary) <br /> Name Horne Address& Telephone <br /> Name Home Address&Telephone <br /> Name Home Address&Telephone <br /> The business address is <br /> "Telephone: Fax: <br /> D. INDIVIDUAL PROPRIETORSHIP <br /> The business address is <br /> Telephone: Fax: <br /> My home address is <br /> � <br /> Telephone: Fax: CheckBoxl <br /> SECTION U. NON-COLLUSION STATEMENT (50ILCS 105/3:65 ILCS 5/3.1-55-10) <br /> A. This bid is made without any connection or common interest in the profits with any other <br /> person other than the Professional Service Provider except as listed on a separate attached <br /> sheet to this affidavit. <br /> Check One: <br /> E] Others Interested in Contract None <br /> B. No department director or any employee or any officer of the City of Decatur has any financial <br /> interest, directly or indirectly, in the award of this contract except as listed on a separate attached <br /> sheet to this affidavit. <br /> G-2 <br />