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Exhibit G <br /> The corporate officers are as follows: I <br /> President: <br /> Vice President: <br /> Secretary: <br /> C. PARTNERSHIP OR LLC I <br /> The partners or members are as follows: (Attach additional sheets if necessary) <br /> Gregg Foltz 6935W. Cantrell,Decatur, IL 62522(217)963-2623 I� <br /> Name Home Address & Telephone , <br /> Kevin Myers 2796 US Highway 51, Clinton, IL 61727 (217)935-5941 ' <br /> Name Home Address& Telephone '! <br /> Dan Jedrzcejak 4180 N. Firestone Drive, Hoffman Estates, IL 60192 (847)358-5744 I <br /> Name Home Address &Telephone <br /> The business address is 5 N. Country Club Road, Decatur, IL 62521 <br /> Telephone: (217)422-8544 Fax: (217)422-0398 <br /> D. INDIVIDUAL PROPRIETORSH[P <br /> The business address is <br /> Telephone: Fax: <br /> My home address is <br /> Telephone: Fax: <br /> SECTION II. NON-COLLUSION STATEMENT �so tt,cs tosi3;6s iLcs si3.�-ss-io> <br /> A. This bid is made without any connection or common interest in the profits with any other <br /> person other than the Consulting Engineer except as listed on a separate attached sheet to <br /> this affidavit. <br /> Check One: <br /> Others Interested in Contract X None <br /> B. No department directar 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 />