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CITY OF LA PORTE <br />CERTIFICATION BY RESPONDENT <br />City of La Porte Ordinance #98-2217 prohibits any expenditure for goods or services by <br />the City of La Porte from any person, firm, or corporation owing any delinquent <br />indebtedness to the City. The undersigned respondent further certifies that it is in <br />compliance with the requirements of said ordinance. A copy of the ordinance may be <br />obtained by contacting the City of La Porte Purchasing Division at 281-470-5126. <br />If undersigned respondent is not in compliance with Ordinance 98-2217, it hereby <br />assigns to the City of La Porte, the amount of its delinquent indebtedness to the City of <br />La Porte, to be deducted by the City of La Porte from the amounts due the undersigned. <br />Failure to remit this certification with the submittal, or non-compliance with said <br />ordinance, shall be just cause for rejection or disqualification of submittal. <br />The undersigned hereby certifies that it is in compliance with Ordinance 98- <br />2217. <br />or <br />The undersigned assigns to the City of La Porte, the amount of its <br />delinquent indebtedness, to be deducted by the City of La Porte from the <br />amounts due the undersigned. <br />(Initial one of the above) <br />Business Name: <br />Address: <br />Printed Name: <br />Authorized Signature: <br />Date: <br />4 <br />