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~. <br />Ohio Revised Code Section 3517 13(J)(3) Certification <br />(For Ohio corporations) <br />The undersigned officer of (name of corporation), an Ohio for profit <br />corporation, acknowledges the provisions of Section 3517.13 of the Ohio Revised Code, <br />which establish certain campaign contribution limits and requirements for contractors that are <br />awarded municipal contracts for goods or services with a cost aggregating to more than ten <br />thousand dollars ($10,000.00) in a calendar year. <br />The undersigned certifies that all of the following persons related to the corporation, as <br />applicable, are in compliance with division (J) (1) of said Section 3517.13: <br />(a) Each owner of more than twenty percent of <br />(name of corporation); <br />(b) Each spouse of an owner of more than twenty percent of <br />(name of corporation); <br />(c) Each child seven years of age to seventeen years of age of an owner of <br />more than twenty percent of (name of <br />corporation); and <br />(d) Any combination of persons identified in paragraphs (a) through (c) above. <br />Note: Whoever knowingly makes a false statement on a certification required by division (J) (3) of Section <br />3517.13 of the Ohio Revised Code is guilty of a felony of the fifth degree, and any contract that includes, or <br />is dependent upon, the certification made in violation of that division shall be rescinded. <br />(NAME OF CORPORATION) <br />BY~ (Name) <br />Its: (Office) <br />Dated: <br />9 <br />