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Exhibit G <br /> The corporate officers are as follows: <br /> President: C� r s 0 ..� <br /> Vice President: -�- <br /> Secretary: C G t ' C �_ <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 /> D. INDIVIDUAL PROPRIETORSHIP <br /> The business address is <br /> Telephone: Fax: <br /> My home address is <br /> Telephone: Fax: <br /> SECTION II. NON-COLLUSION STATEMENT (50 1LCS 10513;65 1LCS 513.1-55-10) <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 /> 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 />