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6.D. - Page 106 of 170 <br />FORM E <br />Request for Qualification <br />City of Los Angeles <br />CERTIFICATION OF COMPLIANCE WITH CHILD SUPPORT OBLIGATIONS <br />This document must be returned with the Response/Bid/ Response <br />The undersigned hereby agrees that - -1-149 PM -JL AC -67-6001 0017)oAW will: <br />Name of Business <br />1. Fully comply with all applicable State and Federal employment reporting requirements for its employees. <br />2. Fully comply with and implement all lawfully served Wage and Earnings Assignment Orders and Notices of <br />Assignment. <br />3. Certify that the principal owner(s) of the business are in compliance with any Wage and Earnings Assignment <br />Orders and Notices of Assignment applicable to them personally. <br />4. Certify that the business will maintain such compliance throughout the term of the contract. <br />5. This certification is a material representation of fact upon which reliance was placed when the parties <br />entered into this transaction. <br />6. The undersigned shall require that the language of this Certification be included in all subcontracts and that all <br />subcontractors shall certify and disclose accordingly. <br />To the best of my knowledge, I declare under penalty of perjury that the foregoing is true and was executed at: <br />m 1 ND N I b0tt605 I NCVADA C� (A <br />City/County/State Date <br />Name of Business <br />X584 6U.5iNE!5S PARKWAY NlNDEN, NV g qA3 <br />Address of Business <br />r 6 <br />_� NARL85 E, KAUFM d <br />Signa re of Authorized Office Representative Print Name <br />Title <br />ES) b97VT <br />?88- W - <br />hone Number <br />660 <br />IMPORTANT - RESPONDERS MUST SUBMIT ALL REQUIRED FORMS (COMPLETELY FILLED OUT) <br />BY RFQ SUBMITTAL DEADLINE. <br />Page 99 of 103 <br />