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Exhibit G <br /> The corporate officers are as follows: <br /> President: John Lardner <br /> Vice President: <br /> Secretary: <br /> C. PARTNERSHIP OR LLC <br /> The partners or members.are as follows:(Attach additional shuts if necessary) <br /> Name Home Address&Telephone <br /> Name Home Address&Telephone <br /> Name Home Address&Telephone <br /> The business address is <br /> Telephone: Fax: <br /> D. 1NDMDUAL PROPREETORSHIP <br /> The business address is <br /> Telephone: Fax: <br /> My home address is <br /> Telephone: Fax: r CheckBoxl <br /> SECTION II. NON-COLLUSION STATEMENT (so rLCs 105/3;65 ILCs 5r3.1-53-10) <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 sgxu-,de attad wd <br /> sheet to this affidavit. <br /> Check One: <br /> El Others Interested in Contract XE]None <br /> B. No department director or any employee or any officer of the City of Decatur has any uncial <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 />