Opening of Bids - One (1) or More, 2021 or Newer, Track Driven Trommel Screen Spec E - Columbus Equipment Company

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NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT AND NONDISCRIMINATION COMMITMENT FOR SELLERS STATE OF INDIANA) ) SS: COUNTY ) The undersigned seller or agent, being duly sworn on oath, says that it has not, nor has any other member, representative, or agent of the fum, company, corporation or partnership represented by him, entered into any combination, collusion or agreement with any person relative to the price to be offered by any person nor to prevent any person from making an offer nor to induce anyone to refrain from making an offer and that this offer is made without reference to any other offer. The prospective seller certifies, by submission of this proposal, that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. The undersigned seller agrees that the following nondiscrimination commitment shall be made a part of any contract which it may henceforth enter into with the City of South Bend, Indiana or any of its agencies, boards or commissions: Seller agrees not to discriminate against any employee or applicant for employment in the performance of this contract with privileges of employment, or any matter directly or indirectly related to employment, because of race, religion, color, sere, handicap, national origin or ancestry. Breach of this provision may be regarded as a material breach of the contract. Dated this Z ,Ik day of - 2021 NATALIE NICODEMUS Seller (Firm) Cckv_ r. t45 qu[Cwtvwl (W1PCr'VC/' Notary Public, State of 01so My Commissbn Explroa lanaagr 24.2m Signature of Seller or Agent Subscribed and sworn to before me this .__ 7 day of N9 1) 40 ftjYj�� 2V2_L. My Commission Expires: I , Z1)-212 Notary Public a' t-� _ .1 County of Residence: ._--- 11