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IV. Except for any work identified above, any bidder or subcontractor that shall perform all or part of the work of the <br /> contract or deliver and install proposal solely by individual owners, partners or members and not by employees to <br /> whom the payment of prevailing rates of wages would be required, check the following box, and identify the <br /> owner/operator workforce and positions of ownership. ❑ <br /> The requirements of this certification and disclosure are a material part of the contract, and th a contractor shall require this <br /> certification provision to be included in all approved subcontracts. The bidder is responsible f r making a complete report <br /> and shall make certain that each type of work or craft job category that will be utilized on the project is accounted for and <br /> listed. The Department at any time before or after award may require the production of a copy of each applicable <br /> Certificate of Registration issued by the United States Department of Labor evidencing such participation by the contractor <br /> and any or all of its subcontractors. In order to fulfill the participation requirement, it shall not be necessary that any <br /> applicable program sponsor be currently taking or that it will take applications for apprenticeship, training or employment <br /> during the performance of the work of this contract or deliver.and install proposal. <br /> Bidder: Illinois Valley Paving,a Division of By: <br /> United Contractors,Midwest,Inc. <br /> Sig nature) <br /> Address: Titl president <br /> 3151 Robbins Road,Springfield,IL 62704 <br /> Printed 7/6/2015 Page 2 of 2 BLR 12325(Rev.4/07) <br />