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Contractor agrees not to discriminate against or intimidate any employee or applicant for <br />employment in the performance of this contract with privileges of employment, or any matter <br />directly or indirectly related to employment, because of race, religion, color, sex, gender <br />expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of <br />this provision may be regarded as material breach of contract. <br />I, the undersigned bidder or agent as contractor on a public works project, understand my <br />statutory obligations to the use of steel products or foundry products made in the United States <br />(I.C. 5-16-8-1). I hereby certify that I and all subcontractors employed by me for this project will <br />use steel products or foundry products on this project if awarded. I understand that violations <br />hereunder may result in forfeiture of contractual payments. <br />*** <br />I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid for <br />public works are true and correct. <br />Dated tlfis , „_ day of� 0J_J <br />Subscribed aild sworn to before Ine (his <br />My Commission Expires. a <br />County of Residence <br />iVtrtory ataxic "- <br />Uncorrriau bounty <br />'y Ct rn r""on xpfr,,, <br />04/14/ 0 0 <br />�CAR <br />MO\,r`w <br />Non -Collusion Non -Debarment Affidavit Non Iran Form <br />4 . .... _._ ..mm <br />Contractor/Bidder (Firm) <br />Signature of Contractor/1:lidder ter Cis g ,t;ertt <br />6 E-_._.[ ! <br />Printed Name and Title <br />Notaryday of <br />Public <br />e� co <br />