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IL Contract -- Consolidated Communications Certifications 2006

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CERnFICATIONS
LEGAL ABllIlY TO CONTRACI; Vendor cer1ffies it is under no legal protWition on contracting with the
State of illinois. has no known confticts of interest and further specifically certifies that:
a)

Vendor, its employees and subcontractors \\ill comply with applicable pro'lisions of the U.S. Civil
Rights Act, Section 504 of the Federal Rehabilitation Act, the Americans with Disabilities Act (42
U.S.C. § 12101 et seq.) and applicable rules in performance under this Contract

b)

Vendor is not in default on an educational loan (5 (lCS 38513).

c)

Vendor has informed the director of the Agencyl&ryer in writing if heIshe was fonnerty employed by
that agency and has received an earty retirement Incentive prior to 1993 under Section 14-108.3
or 16-133.3 of the Illinois Pension Code, 40 ILCS 5114-108.3 and 40 IlCS 5116-133.3, and
acknowledges that contracts made without the appropriate filing with the Auditor GeneraJ are not
payable from the -contractual serkes- or other appropriation line items. Vendor has not received
an early retirement Incentive in or after 2002 under Section 14-108.3 Of 16-133.3 of the RIinois
Pension Code, 40 IlCS 5114-108.3 and 40 IlCS 5/16-133.3, and ac:I<nc7Medges that oontrads in
violation of section 158 of the S1ate FInance Act are not payable from the ·contractual services- or
other appropriation line items (30 Iles 1051158).

d)

Vendor has not been convicted of bnbing Ot attempting to bribe an officer or employee of the State of '
Illinois or any other State, nor has made an admission on the record of having so bribed or
attempted to bribe (30 llCS 500/50-5).

e}

If Vendor has been convicted of 8 felony, at least five years have passed after the date of
completion of !he sentence for such felony, unless no person held responsible by a prosecutor's oft\ce
fot the facts upon which the conviction was based continues to have any involvement with the
business (30 IlCS 500150-10).

f)

If Vendor, or any officer, director, partner, or other managerial agent of Vendor, has been
of a felony under the 5arbar'Ies-Qdey Ad. of 2002, or a Class 3 or aass 2 felony under the
Illinois securities Law of 1953, at least 5 years have passed since the date of the convictlon.
Vendor fur1hef certifies that it is not barred from being awarded a contract and acknowledges that
the contracting State AgencylBuyer shall declare the contract void if this certification is false (30
IlCS 500150-10.5).

con~eted

g)

Vendor and its affiliates are not delinquent In the payment of any debt to the State (or If delinquent
has entered into a deferred payment plan to pay the debt), and Vendor and Its affiliates
ad<noW1edge the contracting State AgencylBuyer may dedare the contract \Qd if this oertitIcaUon 15
false (30 IlCS 500150-11) or If Vendor Ot an afli1ate later becomes delinquent and has not entered
Into a deferred payment plan to payoff the debt (30 Iles 500150-60).

h)

Vendor and all affiliates shall collect and remit illinois Use Tax on all sales of tangible personal
property into the State of Illinois tn accordance with provisions of the Illinois Use Tax Act (30
IlCS 500/50-12) and acknowfedge that failUre to comply can result In the contract being decIanKt
void.
~

i)

Vendor certifies that it has not committed a willful or knowing violation of the Environmental
Protection Act (relaUng to Civil Penalties under the Environmental Protection Act) within the last
five (5) years, and Is therefore not barred from being awarded a contract. if the State tater
determines that this certification was falsely made by the Vendor, the Vendor acknowledges that
the contracting State Agency/Buyer may dectare the contract void. (30 IlCS 500/50-14)

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j)

Vendor has I}Ot paid any money or valuable thing to induce any person to refrain from bidding on a
State contract. nor has Vendor accepted any money or other valuable thing, or acted upon the
promise of same, for not bidding on a State contract (30 JLCS 500150-25).

k)

Vendor is not in violation of the -Revolving 000( section of the IRinois ProoJrement Code (30 ILCS
500/50-30).

I)

Vendor will report to the IIUnois Attomey General and the Chief Procurement Officer any suspected
collusion or other anti-competitive practice among any bidders, offerors, contractors, proposers
or employees of the State (30 llCS 500/50-40. 50-45, 50.50).

m)

Vendor will, pursuant to the Drug Free Wor1<pface Act, provide a drug free wOr1(place, and if an
individual shall not engage In the unlawful manufacture, distribution. dispensation, possession or use
of a controlled substance in the perfonnance of the Contract. This cerUfication applies to
contracts of $5000 or more with: individuals; and to entities with twenty-five (25) or more
employees (30 ILCS 580).

n)

Neither Vendor nor any substantially owned affiliate Is partlcipatlng or shall participate in an
international boycott in violation of the U.S. Export Administration Act of 1979 or the applicable
regulations of the U.S. Department of Commerce. This certification applies to contracts that
exceed $10,000 (30 ILCS 582).

0)

Vendor has not been convicted of the offense of bid rigging or bid rotating or any similar offense of
any State or of the United States (720 JlCS 5I33E-3. Sl33E-4).

p)

Vendor complies with the Illinois Department of Human Rights Act and rules applicable to pUblic
contrac1s, including equal employment oppcr1unity, refraining from unlawful cflSaimnation. and haW1g
written sexual harassment policies (775IlCS 5/2-1(5).

q)

Vendor does not pay dues to, or reimbt.Kse or subsidize pa)fYleOts by its employees for, any dues or
fees to any -discriminatory club- (775 ILCS 2512).

r)

Vendor complies with the State Prohibition of Goods from Forced Labor Act, and certifles that no
foreign-made equipment. materials, or supplies furnished to the State under the contract have
been or will be produced In whole or in part by forced labor, convict labor, or indentured labor under
penal sanction (PA 93-0307).

s)

Vendor certit1es that no foreign-made equipment. matenals, or supples furnished to the State under
the contract have been produced in whole 0( il part by the labor of any child under the age of 12 (PA
94-(264).

t)

Vendor certffies that it is not In violation of section 5()'14.5 of the IIIlnols Procurement Code that states:
-CNmers of residential buildings who have committed a willful or knowing vtoIaUon of the lead
Poisoning PreventJon ~ (410 ILCS 45) are prohibited from doing business wi1h the State of IUinois or
any Slate agency until the violation is mitigated".

u}

CONFLICTS OF INTERESTj Vendor has disclosed, and agrees it is under a continuing
obligation to disclose to the Agencyl8uyer, financial or other Interests (pUblic or private, direct or
indirect) that may be a potential conflict of interest or which would prohibit Vendor from haW'lg or
continuing the Con1rSct. this indudes, but is not limited 10 conflicts under the -lrlras1rUdUre Task
Foree Fee Prohibition- section of the State Finance Act (30 ILCS 10518.40), Artide 50 of the 1JJinois
Procurement Code (30 ILCS 500150), or those YAlIc:h may conflict in any manner \Wh the Vendor's
Obligation under this Contract Vendor shaD not employ any person with a conflict to perform under
this Contract. If any conflict under Section 50-13 exists no contract may be Issued without an

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exemption from the Goveq\or pursuant to section 50-20 of the Imnois Procurement Code, An
exemption is necessary If:
1)
the person intending to contract with the State, their spouse or child: (i) holds an
elective office in Illinois: (ii) holds a seat In the Illinois General Assembly; (iii) is an officer
or employee of the Q1pitaI DewJopment Board or the lIinois Tol Highway Authority; or holds
an appointed posJtJon or is employed In any of the offices or agendes of the State
government and who receives ccmpensaUon for such empb~nt in excess of 60% of tie
salary ct the Governor (currentty $90."14.60), (The conflict of Imetest ttYeshoId of 60% of
the Governor's salafy set foI1h In Section 50-13 does not apply to elective otnce holders,
legis8tors, and officers or emptoyees of the Capital Development Board or the Illinois Toll
Highway Authority,);
2)
the contract is with a firm, paltnershlp, association or corporation In v-tlich a person
refetenced in 1) above receives more than 7,5% of the total dIstributable Income or an
amount In excess of the salary of the Governor (CUJT'MltIy $150.691.00),
3)
the contract Is with a firm. partnership. association or corpc:ntion in which a person
referenced in 1) above, together.wlth their spouse or minor dlIld. receives more than 15%
in the aggregate of the total distributable income or an amount In excess of 2 times
the salary of the Governor (currently $301,382.00) from the finn, partnership,

association or corporation,

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VENOOR (show Company name and DBA)

Coasol~U

l!.ownun'tf4±'P1' 5

Signature_

tub/I't. SUV;uS, L.~.

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Printed Name_

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Date

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CMS12-o1-06

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Taxpayer l,dentJflcation Number

I certify that:
1. The number shown on this form is my correct taxpayer Identification number (or t am
waiting for a number to be issued to me). and
2. I am not subject to backup withholding because: (a) I am exempt from backup
withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I

am subject to backup withholding as a result of a failure to report all Interest or
dividends, or (e) the IRS' has notified me that I am no longer subject to backup
withholding. and
3. I am a U.S. person (including a U.S. resident alien).

Name (Printed):

,Conspk.c!a:kLeom.mU13iC4b'onS 'tb~·c. SUVI·C~S; .. ~C.

Taxpayer Identlflcat10n Number:

Social Securlty Number

_

or
Employer Identification Number_

Legal Status (check one):
_Individual

_Governmental

_ _Sole Proprietorship

_Nonresident alien

_Partnership/Legal Corporation

_Estate or Trust

_ _Tax-exempt

_Phannacy (non-corporate)

_Corporation provk1lng or
billing medical and lor
health care servtces

_Phannacy/Funeral Horne/cemetery (Corp.)

Leorporation NOT providing
or billing medical and I or
health care services

_Other

_

eMS 12..Q1-oa