Laserfiche WebLink
0 0 0 .1.1 1 1 A A <br />BID INAME Spec V — One or More 2018 or Newer 50 Ton Paver Special Trailer <br />FOR BIDS DUE September 25, 2018 at 9:30 a.m. <br />Date: 9-20-18 <br />Bidder <br />(Firm): Southeastern Equipment Co,., Inc. <br />Address,: 3333 West Colisuem Blvd. <br />City/State/Zip: Fort Wayne, IN. Telephone Number ( 260 )483-8868 <br />Agent of Bidder (if Applicable,): John Koch <br />When the prospective Contractor is unable to eertify to any of the statements belotp, it shall attach an explanation to this Affidavit. <br />CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT, <br />CERTIFICATION REGARDING INVESTMENT WITH IRAN, EMPLOYMENT <br />ELIGIBILITY VERIFICATION, NON-DISCRIMINATION COMMITMENT AND <br />CERTIFICATION OF USE OF UNITED STATES STEEL PRODUCTS OR FOUNDRY <br />PRODUCTS <br />(Must be completed for all quotes and bids. Please type or print) <br />I <br />jTE OPDr01_6-&a__,) <br />) SS: <br />COUNTY <br />The unidersigned Contractor, being duly sworn upon his/her/its oath, affirms tinder the penalties of pet jury <br />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 induce 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. 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, or voluntarily excluded from participation in this transaction by any Federal <br />department or agency; and <br />3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in <br />investment activities in Iran. <br />a. For purposes of this Certification, "Iran" means the government of Iran and any <br />agency or instrLimentality of Iran, or as otherwise defined at Ind. Code § 5-22-16,5-5, <br />as arnended from time -to -tune. <br />2 <br />