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<br />CITY OF LA PORTE <br /> <br />CERTIFICA rlON BY BIDDER <br /> <br />The undersigned bidder hereby certifies it has been furnished a copy of City of La Porte <br />Ordinance #98-2217 prohibiting any expenditure for goods or services by the City of La <br />Porte from any person, firm, or corporation owing any delinquent indebtedness to the <br />City. The undersigned bidder further certifies that it is in compliance with the <br />requirements of said ordinance. <br /> <br />If undersigned bidder is not in compliance with Ordinance 98-2217, it hereby assigns to <br />the City of La Porte, the amount of its delinquent indebtedness to the City of La Porte, to <br />be deducted by the City of La Porte from the amounts due the undersigned. <br /> <br />Failure to remit this certification with the bid, or non-compliance with said ordinance <br />shall be just cause for rejection or disqualification of bid. <br /> <br />...Dl2 The undersigned hereby certifies that it is in compliance with Ordinance 98-2217. <br /> <br />or <br /> <br />_ The undersigned assigns to the City of La Porte, the amount of its delinquent <br />indebtedness, to be deducted by the City of La Porte from the amounts due the <br />undersigned. <br /> <br />(Initial one of the above) <br /> <br />Business Name: <br /> <br />'b.\...DA\1\t)~t-J (DN1RA.(1Oe~ \tJL, <br />\<:r12~ 5/Wlv'\$ ~D r~B itlLS <br />t-t-O,Y3TOtJ \X <110 lJY <br />(l...J IJ~~ <br />, <br />DJ\tJ\EL \)~vu>-:otJ <br /> <br />Address: <br /> <br />Authorized Signature: <br /> <br />Printed Name: <br />