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STATE AY & n,M <br />COUNTY SS: <br />"'f �, MiM �., iM''": ,i �` "� « 1i ,' Z �� ,M M ,� rf1; ,�,"": • IN <br />2. Contractor certifies by submission of this proposal that neither contractor nor any <br />of its principals are presently debarred, suspended, proposed for debarment, declared <br />ineligible, from participation in this transaction by any d, <br />departmentor agency;and <br />& Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged ir <br />investment activities in Iran. <br />-7,. For purposes of this Certification, 'Iran" means the government of Iran and any <br />agency or instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, <br />as amended f♦ ' <br />Non -Collusion Non -Debarment Affidavit Non lmn Form 2016 <br />