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• <br />t <br />EXHIBIT G <br />NON- DEBARMENT, NON- COLLUSION AND <br />NON - DISCRIMINATION AFFIDAVIT <br />STATE OF INDIANA ) <br />) SS: <br />COUNTY OF ST. JOSEPH ) <br />The undersigned d/b /a The State Cafd & Catering ( "Tenant "), being duly sworn on oath, hereby certifies as <br />follows: <br />1. That the undersigned is duly authorized and is competent to certify to the statements contained <br />herein on behalf of Tenant. <br />2. That neither the Tenant nor any other entity under its control are presently debarred, suspended, <br />proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction <br />by any Federal department or agency. <br />3. That Tenant has not, nor has any other member, representative, or agent of the business entered <br />into any combination, collusion or agreement with any person relative to the price to be offered by any <br />person nor to prevent any person from making an offer nor to induce anyone to refrain from making an <br />offer and that this offer is made without reference to any other offer. <br />4. That Tenant hereby agrees to abide by the following nondiscrimination commitment, which shall <br />be made a part of any contract that Tenant may henceforth enter into with the City of South Bend, Indiana <br />or any of its agencies, boards or commissions: <br />Tenant agrees not to discriminate against any employee or applicant for employment in <br />the performance of this contract with privileges of employment, or any matter directly or <br />indirectly related to employment, because of race, religion, color, sex, handicap, national <br />origin or ancestry. Breach of this provision may be regarded as a material breach of the <br />contract. <br />BRENDA C. MARKIN d/b /a THE STATE CAFE & <br />CATERING, Tenant <br />Brenda C. Markin <br />Subscribed and sworn to before me this day of January, 2006. <br />My Commission Expires: <br />County of Residence: <br />(SEAL) <br />Notary Public <br />F.IDATAISHARETegallWpdatatSEPl Economic DevetopmentlBtllie'slState Cafe Mate Cafe Lease (version 5).doc <br />