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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).1 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 under 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 10 day of 1rAOV , 20AV <br />Subscribed and sworn to before me this <br />My Commission Expires _2 <br />s .a _ _ County of Residence <br />FUZABETH C OBED <br />No:a Nubim, State of Indiana <br />st Joseph Coun <br />O MY iiommlaslon Fx�plras <br />ril2t 2022 <br />Non -Collusion Non -Debarment Affidavit Non Iran Fomr <br />liiS or1GFrLseryn+i�h <br />Contractor/Bidder (Firm) <br />Signaturb of Contractor/Bidder or Its Agent <br />9i(Ir-1T-OrtSe( <br />Printed Name and Title <br />.L <br />