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The corporate officers are as follows: <br /> President: <br /> Vice President: <br /> Secretary: <br /> C. PARTNERSHIP OR LLC <br /> The partners or members are as follows: (Attach additional sheets 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 /> My home address is <br /> Telephone: Fax: <br /> D. INDIVIDUAL PROPRIETORSHIP <br /> The business address is 53 W. Jackson, Suite 1664, Chicago, Illinois 60604. <br /> Telephone: 773-818-4825 <br /> My home address is: 7100 N. Greenview, Chicago, Illinois 60626 <br /> Telephone: Fax: <br /> SECTION II. NON-COLLUSION STATEMENT (50 ILcs 10513;65 ILCS 513.1-55-10) <br /> A. This proposal, bid or contract is made without any connection or common interest in the <br /> profits with any other person other than the Service Providers except as listed on a <br /> separate attached sheet to this affidavit. <br /> 1 <br />