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CITY OF SOUTH BEND INDIANA <br />SELLER'S BID FOR SALE OR LEASE OF MATERIALS <br />® NONmC®LLlJS10N AN® N®N RMENT AFFIDAW E1-NN ,, <br />NON-DISCRIMINATION COMMITMENT FOIE S� <br />Janitorial Supplies 2018 <br />"` ` - _'^:`• ?�= june 12, 2018 9:34 a.m., local time <br />- 06 11 18 Bidder SAWCO DISTRIBUTING I(�k <br />(Firm): <br />919 I Jo OLIVE ST -- -- . <br />SOUTH BE D I 46� --- - <br />---_ e ephone Number: <br />(574 ) 282 2$10 <br />Applicable): JOHIJ SAI DERS <br />. ° ,_-�. �;:,� �'nsfprr�e•Poei.5 a4�tczhle try certif try nn3of tdie statefazents 6elo►v, it,slar�ll rrrtrgelz c:,; ��:;; ..., . <br />_ ti T'F .RALC`I'ORIS NON -COLLUSION AND NON-DEBARM NT' <br />ERIFICATION REGARDING INVESTMENT WITIJIRAN, -MP ry� <br />>IEk cA�AT, O—DISrRyNIei�!kN s' ICATION OF USE OF UNITED STATES STEEL I?RODUC- S u_'Nk" <br />PRODUCTS <br />(Must be completed for all quotes and Kids. Please type or pri,it) <br />i. ItJDIA A <br />ST JOSEPH )Ss-. <br />COUNTY } <br />l..'. 5igr.�d Contractor, being duly sworn upon his/her/its oath, affirms tinder the <br />i. Contractor has not, nor has any other member, representative, or <br />company, corporation or partnership represented by him, entered into �; :_-,;;,j;;•.,,;.: ,, <br />collusion or agreement with any person relative to the price to be bid <br />� IM9 nor to prevent any person from bidding nor to induce anyone <br />-,idding, and that this bid is made without reference to any other bid <br />:;rcernent; understanding or combination with any other person in <br />`ridding. Contractor further says that no person or persons, firms, or cor�r�r <br />or "N/ill receiVe directly or indirectly, any rebate, fee, gift, cornmissio?- o� <br />Oil acc011111 of such sale; and ` <br />Contractor- certifies by submission of this proposal that <br />�A its principals are presently debarred, suspended, proposed for <br />i r li ible, or voluntarily excluded frorn participation in this transacts".; ; y <br />dcrpartrnent or agency, and <br />�. Contractor has not, nor has any .successor to, 1`1or an affiliate. of, Caner:= <br />:3vestrnent actkvities in Iran. - <br />