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CO of La Porte <br />NM Mill K91,2ZI-261 0001 DO 4-011111 <br />Section 00300 <br />City of La Porte Forms <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 />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 />111i FIRMS WEI i PRIME Ill <br />roulwo ME�= � <br />Failure to remit this certification with the response or non-compliance with said <br />ordinance shall be just cause for rejection or disqualification of submitted proposal. <br />WWPThe undersigned hereby certifies that it is in compliance with Ordinance 98-2217. <br />Or <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 />EM3= <br />(Initial one of the above) <br />Business Name: W.W. Payton Corporatin <br />Address: P.O. BOX 10-M. <br />Katy, Texas 77492 <br />Printed Name: Wesley W. Paytpn - President <br />Authorized Signature: <br />Date: 3-19-19 <br />