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whert Ilre peaspective C0111ractor. is. mable.to: eerrtify� to any of ille statements below, It shall attach as arplanation to this:Affrrlapit, <br />CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT, <br />CERT'iFiCAA;TION REGARDING INVESTMENT WITH IRAN EMPLOYMENT ELIGIBILITY <br />VERARCATI()N, NON-DISCRIMINATION COMMITMENT AND CERTIFICATION OF USE <br />OF UNITED STATES .STEEL PRODUCTS OR FOUNDRY. PRODUCTS <br />(Must becompleted for all quo#es and'bicls. Plene.type a' pciint) <br />STATE OF Indiana )' <br />$S <br />St: Joseph COUNTY <br />Tito undersigned,Gontractor, being duly.swornupan hisLlerlits::oath; affirms.urtder,the:penalties of perjury thaf, <br />I., Contractor has', not, 'nor has !any :other' metinbet representative, or agi.ent of the firm, <br />company, corporation.or partnership represented by him, entered into arty combtnatian, colluslori <br />or agreement,. with any person relative to the price to be bid by anyone. at such, idting nor to <br />prevent any person frown bidding nor to induce anyone to refrain' from :bidding; and that this bid <br />is' made` without. reference to any, :tithe"r, bid and W.J. ut any agreement. understanding ,or <br />corttbination with any tither person iri reference to such bidding. Contractor further: says that no <br />person or persons, ltrris, or corporation has, iiaye, or will reaelye directly or indirectly;; any <br />rebate;'fee, gifit; irommssian o' thirg'af value on account of such sale,, arid. <br />2: Contractor certifies by submission :of this proposal :fhat neither .contractor nor any: Of its:. <br />principals are presently debar red; suspended, proposed for debarment, declared -ineligible, cir <br />Voluntarily excluded from participation in this transaction by arty Federal departincrit or agency; <br />and <br />3, Contractor ' bas. not, nor. has any successor 'to, ;nor arc affillattr >of, Con ractor_ engaged in <br />investment Activities iii Iran:. <br />A; For purposes of this Certification;;"Irani" means the,government.of Iran and. any agency or <br />it►strumentality, of lrani ot:as otherwise derined al Ind. Code § 5=.�2 i6.5: 54as-amended from <br />ti�ne�fo tEnte <br />b. As.providedby Ind Code § 5 22-1$;5»8; as amended fto'm time -to -time: a Contractor is <br />engaged h fnvestmerit activities.In (ran if either: <br />i.. Contractor, its successor or its affiliate, provides goods or sere ces.of lwelity Million. <br />dollars ($20,000,000) or more in vague in the energy sector of Iran; or <br />ii.. 'Contractor;' its successor or its affiliate, isa, financial.institution that extends twenty <br />million dollars {$2Q;000,000) or iilare in credit to'ariather'pers66.for forty-five (45)' <br />days or more, if that person will. (i.) use the credit to provides goods and'services in <br />F-Non-&Musson Non•t7eWrment A01421vit Nora Iron 1'oini2012 <br />