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CONTRACTOR'S NON - COLLUSION AFFIDAVIT, NON - DEBARMENT AFFIDAVIT,
<br />EMPLOYMENT ELIGIBILITY VERIFICATION, NON - DISCRIMINATION COMMITMENT
<br />FOR CONTRACTORS AND CERTIFICATION OF USE OF UNITED STATES STEEL
<br />PRODUCTS OR FOUNDRY PRODUCTS
<br />(Must be completed for all bids. Please type or print)
<br />STATE OF INDIANA
<br />SS:
<br />COUNTY
<br />The undersigned Contractor, being duly sworn upon his/her /its oath, affirms under the penalties
<br />of perjury that:
<br />1. Contractor has not, nor has any other member, representative, or agent of the firm,
<br />company, corporation or partnership represented by him, entered into any combination, collusion
<br />or agreement with any person relative to the price to be bid by anyone at such letting nor to
<br />prevent any person from bidding nor to induce anyone to refrain from bidding, and that this bid
<br />is made without reference to any other bid and without any agreement, understanding or
<br />combination with any other person in reference to such bidding. Contractor further says that no
<br />person or persons, firms, or corporation has, have or will receive directly or indirectly, any
<br />rebate, fee, gift, commission or thing of value on account of such sale; and
<br />2. Contractor certifies by submission of this proposal that neither contractor nor any of its
<br />principals are presently debarred, suspended, proposed for debarment, declared ineligible, or
<br />voluntarily excluded from participation in this transaction by any Federal department or agency;
<br />and
<br />3. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain
<br />any employee or contract with a person that the Contractor subsequently learns is an
<br />unauthorized alien. Contractor agrees that he /she /it shall enroll in and verify the work eligibility
<br />status of all of Contractor's newly hired employees through the E -Verify Program as defined by
<br />I.C. 22- 5- 1.7 -3. Contractor's documentation of enrollment and participation in the E -Verify
<br />Program is included and attached as part of this bid/quote; and
<br />4. Contractor shall require his/her /its subcontractors performing work under this public
<br />contract to certify that the subcontractors do not knowingly employ or contract with an
<br />unauthorized alien, nor retain any employee or contract with a person that the subcontractor
<br />subsequently learns is an unauthorized alien, and that the subcontractor has enrolled in and is
<br />participating in the E -Verify Program. The Contractor agrees to maintain this certification
<br />throughout the term of the contract with the City of South Bend, and understands that the City
<br />may terminate the contract for default if the Contractor fails to cure a breach of this provision no
<br />later than thirty (30) days after being notified by the City.
<br />5. Persons, partnerships, corporations, associations, or joint venturers awarded a contract by
<br />the City of South Bend through its agencies, boards, or commissions shall not discriminate
<br />against any employee or applicant for employment in the performance of a City contract with
<br />respect to hire, tenure, terms, conditions, or privileges of employment, or any matter directly or
<br />indirectly related to employment because of race, sex, religion, color, national origin, ancestry,
<br />age, or disability that does not affect that person's ability to perform the work.
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