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<br />The undersigned bidder hereby certifies it has been furnished a copy of City of La Po' <br /> <br />.......(jrdlnanq;l fS8-2217 prohibiting any expenditure for goods or services by the City of t <br /> <br />.... .. '''i.~orte from any persori, firm, or corporation owing any delinquent indebtedness to tl' <br />i>"r~fj+ ;' >}1',L> <br />"""';,C!ty. The undersigned bidder further certifies that it is in compliance with tf <br />~. <br />~, " <br />... requirements of said ordinance. <br /> <br />"'-'i <br /> <br />Al.lthorized Signature: <br />'1',";'; <br /> <br /> <br />~~, <br /> <br /> <br />~-~" . <br />>'''\t <br /> <br /> <br /> <br /> <br /> <br />CITY OF LA PORTE <br />CERTIFICATION BY BIDDER <br /> <br /> <br />Ifl.lnde~igned bidderisnot in compliance with Ordinance 98-2217, it hereby assigns <br />..the City of~ Porte, the amount of its delinquent indebtedness to the City of La Porte, <br />~eded~cted 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 ordinant <br />shall be just cause for rejection or disqualification of bid. <br /> <br /> <br />~~U"del1!illn~ herel;>y certffies that ~ is in compliance w~h Ordinance 98-221 <br /> <br />or <br /> <br />___ The unc;lersignCitd assigns to the City of La Porte, the amount of its delinquent <br />indeQtedness,to be deducted by the City of La Porte from the amounts due the <br />undersigned. <br /> <br />,(Initial one ofth(J above) <br /> <br />Bu.iness Name: <br /> <br />I/I}f)JJ ~allT-(' pr, <br />/.ff) / ~ 1Jik-;(/ ~tlf/1tJ <br />~/Jf;!;' 7i 77$()l( <br /> <br />f--tMf ~/'k <br /> <br /> <br />Address: <br /> <br />.~,'. ;,Printed Name: <br />