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,,4_: , , „ , Exhibit G <br /> . <br /> . <br /> B. No department director or any employee ar 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 /> C. That the Bidder/Contractor is not barred from bidding on any contract as a result of violation of <br /> 720 ILCS 5/33E-3 and 5/33E-4 (Bid Rigging ar Bid Rotating). <br /> SECTION III. DRUG FREE WORKPLACE AND DELINQUENT ILLINOIS TAXES STATEMENT <br /> The undersi�,med states under oath that the Consulting Engineer is in full compliance with the Illinois <br /> Drug Free Workplace Act, 30 ILCS 580/l,et. seq. The undersigned also states under oath and certifies <br /> that the Consulting Engineer is not delinquent in payment of any tax administered by the Illinois <br /> Department of Revenue except that the taxes for which liability for the taxes or the amount of the taxes <br /> are being contested in accordance with the procedures established by the appropriate Revenue Act; or that <br /> the Consulting Engineer has entered into an agreement(s)with the Illinois Department of Revenue for the <br /> payment of all taxes due and is in compliance with the agreement. (65 ILCS 5/11-42.1-1) <br /> SECTION N. FAMILIARITY WITH LAW S STATEMENT <br /> The undersigned, being duly sworn, hereby states that the Consulting Engineer and its employees are <br /> familiar with and will comply with all Federal, State and local laws applicable to the project, which may <br /> include, but is not limited to, the Prevailing Wage Act and the Davis-Bacon Act. <br /> CONS TING ENGIN <br /> � <br /> ig a ure <br /> �oi �� l. �/� <br /> Pr' t d Name <br /> l�an�t�i�rq �a���'' <br /> Title <br /> SUBSCRIBED and SWORN to before me this�day of�1�1�1�� , 20��. <br /> Notary Public <br /> ;.....a��f4�-♦4+♦♦♦♦4♦♦+4 <br /> "OFFICIAL SEAL" ♦ <br /> + SUSAN R MARVIN ♦ <br /> hfOTARY PUBLIC,STATE OF ILLINOIS ♦ <br /> 'AY COMMISSION EXPIRES 06-10-2013 ♦ <br /> r-w i�♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦ <br /> G-3 <br />