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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 handicap, <br />national origin or ancestry. Breach of this provision may be regarded as material breach of <br />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). 1 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 />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 this day of Y (2av , 10 C "J. <br />w, <br />" LORYLTUM <br />� wr, <br />X l <br />Con�ctorB�_.....W.11�.e����j_�'.���.�..��w�_H <br />(c , dd/e'r (,Firm) <br />SI nature of Contractor) Ic cl�:r�� g or Its Agent <br />Printed Name and Title <br />Subscribed and sworn to before me this day of <br />My Commission 1 p tprresm <br />o dry ublic <br />County of Residence4 <br />7I <br />F-Non-Collusion Non -Debarment Affidavit Non [ran Form 2012 <br />20-L9 <br />i YK4.VLW <br />