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6B (5)
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10-11-11 Packet
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6B (5)
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11/1/2012 12:37:40 PM
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10/7/2011 11:59:21 AM
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When the prospective Contractor is unable to certify to any of the statements below, it shall attach an explanation to this Affidavit. <br />NON - COLLUSION, NON - DEBARMENT AFFIDAVIT, EMPLOYMENT ELIGIBILITY <br />VERIFICATION AND NON - DISCRIMINATION COMMITMENT <br />STATE OF INDIANA ) <br />) SS: <br />ST. JOSEPH COUNTY ) <br />The undersigned Contractor, being duly sworn upon his/her /its oath, affirms under the <br />penalties of perjury that: <br />I . 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, <br />collusion or agreement with any person relative to the price to be bid by anyone at such <br />letting nor to prevent any person from bidding nor to include anyone to refrain from <br />bidding, and that this bid is made without reference to any other bid and without any <br />agreement, understanding or combination with any other person in reference to such <br />bidding. Contractor further says that no person or persons, firms, or corporation has, have <br />or will receive directly or indirectly, any rebate, fee, gift, commission or thing of value <br />on account of such sale; and <br />2. Neither Contractor nor any of its principals are presently debarred, suspended, <br />proposed for debarment, declared ineligible, or voluntarily excluded from participation in <br />this transaction by any Federal department or agency; and <br />3. Contractor does not knowingly employ or contract with an unauthorized alien, nor <br />retain any employee or contract with a person that the Contractor subsequently learns is <br />an unauthorized alien. Contractor agrees that he /she /it shall enroll in and verify the work <br />eligibility status of all of Contractor's newly hired employees through the E- Verify <br />Program as defined by I.C. 22- 5- 1.7 -3. Contractor's documentation of enrollment and <br />participation in thee- Verify Program is included and attached as part of this bid/quote; <br />and <br />4. Contractor shall require his/her /its subcontractors performing work under this <br />public contract to certify that the subcontractors do not knowingly employ or contract <br />with an unauthorized alien, nor retain any employee or contract with a person that the <br />subcontractor subsequently learns is an unauthorized alien, and that the subcontractor has <br />enrolled in and is participating in the E- Verify Program, The Contractor agrees to <br />maintain this certification throughout the term of the contract with the City of South <br />Bend, and understands that the City may terminate the contract for default if the <br />Contractor fails to cure a breach of this provision no later than thirty (30) days after being <br />notified by the City; and <br />
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