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NON-COLLUSION DISCLOSURE <br /> Easter Seals Central Illinois, Inc. shall disclose, to the best of its knowledge, any employee of the <br /> City of Decatur or member of the State legislature, or any relative of any such officer or <br /> employee who is an officer or director of, or has a material interest in, the agency's business, <br /> who is in a position to influence this Agreement. <br /> Name Relationshi s <br /> J) .-�„ / �, V//� �^ � � C-L /S / 7 ' �/ <br /> Company Name: Easter Seals Central Illinois, Inc. <br /> Authorized Representative: Debra L. England <br /> Title: President <br /> Signature: <br /> b� �i <br /> Date: _ f� ` <br /> / �0%D <br /> 16 <br />