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TY <br />SELLER'S I III � SALE BEND <br />�'A� I11AiylA <br />AND O"1MI-I OLL��1 3h1 AND NON CDE�A�MEOhI �AFE RIAL; <br />BID NAME Venues Parks & Arts 2 EOII MITMENT FOR SE AVIT <br />tIV-E"I�0�111J1I ATII <br />FOR BIDS DUE JJanua 1�Irh 2020 9:30 amOlaerrt%oal Su 1 LL�P � <br />Date: 1 /9/20 <br />Address: PO Box 807 <br />City/State/Zip: L—kel n , FL 2 <br />Agent of Bidder (if Applicable): n/a <br />Bidder <br />(Firm): <br />810 28-0 <br />When tllt`PrrrsPeative ("eMtrrrc"t" 1'� 1 <br />1 <br />11 <br />al Ito tea eerte 10 ara A f <br />r ,f the strrtexrrrerrts /rxeto � iP s III%/ attac it cr�r c a��larrati � <br />"O1" 1'11tA C'fi+OII '�y NON -COLLUSION � c` xa trr t1r1:s A <br />AND N lJidaver. <br />CERTIFICATION 1t.F�GA1tr�I+IC;� If'+i�"E"�" 1 iL�IW�13Ai�M <br />1+�T�.1 ERTI 1 C TI �1�p AFFIDAVIT� <br />TMI"l.f, °I�'i°I"1-1 ii�Al'�, LM1"L+LN'I�"MEI'1" <br />I� ICAT"I+ON,NON-DISCRIMINATION COMMITMENT <br />AND <br />CERTIFICATION OF USE OF UNITED Ia STATES STEEL I'01)I:tCTOR1�I�' �� <br />PRODUCTS C`I`, <br />Harrell's, LLC <br />Telephone Number: <br />(Must be completed for all quotes and bids. Please type or print) <br />) <br />STATE OF 1w L0R_ DA <br />POLK COUNTY j SS: <br />The undersigned Contractor, being duly sworn upon his/her/its <br />that: oath, affirms <br />under the penalties of perjury <br />l Contractor has not, rtor has any othcr Mcniber, represerltati <br />company, corporation or partnership represented by him, entered irrta <br />collusion or trgrcert�rcrtt °vvrth art �"�, or agent ol`the firm„ <br />uch <br />lettirr y person relative to the price to 17c bid b ally corttbirratiort, <br />g nor- to prcverrt any persorr frorrt bidding <br />bidding, and that this bid is made without reference to rrrt Other y anyone at Orr <br />agreement, understanding or combination g nor to induce arryortc to rel�ain li•ortr <br />bidding. Contractor leather says that no person or n y ter bid and without arty <br />or will receive directly 01, indirectly, an e r other person rrills', or rr reference to such <br />account of such sale; and <br />bate, fie, gift co mrniwssion orthing <br />poion has, have <br />g l value on <br />2. Contractor certifies by submission of this Proposal that <br />Of its principals are presently debarred <br />ineligible, principals <br />voluntarily are Pre excluded from rtford barment, nor any <br />suspended, proposed for debarment, declared <br />depar°trnent or agency; and participation in this transaction b ., <br />y any f"c�derrra <br />3. Contractor has not, nor has any successor to, nor an affiliate of C <br />investment activities in Iran. <br />ontractor, engaged in <br />