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Contractor agrees not to discriminate against or intimidate any employee or applicant. for <br />employment in the performance of this contract with privileges of employment, or any matter <br />directly or indirectly related to employment, because of race, religion, color, sex, gender <br />expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of <br />this provision may be regarded as material breach of contract. <br />I, the undersigned bidder or agent as contractor on a public works project, understand my <br />statutory obligations to the use of steel products or foundry products made in the United States <br />(I.C. 5-16-8-1). I hereby certify that I and all subcontractors employed by me for this project will <br />use steel products or foundry products on this project if awarded. I understand that violations <br />hereunder may result in forfeiture of contractual payments. <br />I hereby affirm tinder the penalties of perjury that the facts and information contained in the foregoing bid for <br />public works are true and correct. <br />Dated this day of , 2016 <br />khr1 oyds2V a-ilh(AVlWiC, <br />Contractor/Bidder (Firm) <br />kQk�= <br />Signatut of Contractor/Bidder or Its Agent <br />�pq$2( up�J'!� Q'VeC}nr <br />Printed Name and Title <br />Subscribed and sworn to before me this ram day of 20� <br />My Commission Expires <br />IAURAAUHOFF 6NotatyPublic <br />Notary Pob, <br />io. Sh Coo ntydran <br />.•`o,qa�, St. Josef <br />•�= Commiss'on (! ME l�L'22 e5ldenCe <br />•. 202261 <br />•. SEAS : MV COrnmia lion EaP <br />,. ....... e.,tiruaty 03, <br />Non -Collusion Non-Debannent Affidavit Non Iran Fonn <br />