My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
Opening of Bids - Studebaker National Museum Roof Restoration & Replacement Proj No. 122-030 - Slatile Roofing & Sheet Metal Co.
sbend
>
Public
>
Public Works
>
Board of Works Documents
>
2022
>
Opening of Bids
>
Opening of Bids - Studebaker National Museum Roof Restoration & Replacement Proj No. 122-030 - Slatile Roofing & Sheet Metal Co.
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
6/14/2022 2:23:45 PM
Creation date
6/14/2022 2:23:07 PM
Metadata
Fields
Template:
Board of Public Works
Document Type
Projects
Document Date
6/14/2022
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
23
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
Show annotations
View images
View plain text
When the prospective Contractor is unable to certify to any of the statements below, it shall attach an explanation to this Affidavit. <br />CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT, CERTIFICATION <br />REGARDING INVESTMENT WITH IRAN, EMPLOYMENT ELIGIBILITY VERIFICATION, NON- <br />DISCRIMINATION COMMITMENT AND CERTIFICATION OF USE OF UNITED STATES STEEL <br />PRODUCTS OR FOUNDRY PRODUCTS <br />(Must be completed for all quotes and bids. Please type or print) <br />STATE OF Indiana ) <br />) SS: <br />St. Joseph COUNTY ) <br />The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury <br />that: <br />1. Contractor has not, nor has any other member, representative, or agent of the firm, company, <br />corporation or partnership represented by him, entered into any combination, collusion or agreement with <br />any person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding <br />nor to induce anyone to refrain from bidding, and that this bid is made without reference to any other bid and <br />without any agreement, understanding or combination with any other person in reference to such bidding. <br />Contractor further says that no person or persons, firms, or corporation has, have or will receive directly or <br />indirectly, any rebate, fee, gift, commission or thing of value on account of such sale; and <br />2. Contractor certifies by submission of this proposal that neither contractor nor any of its principals <br />are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from <br />participation in this transaction by any Federal 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 agency <br />or instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as <br />amended from time -to -time. <br />b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor <br />is engaged in investment activities in Iran if either: <br />L Contractor, its successor or its affiliate, provides goods or services of twenty <br />million dollars ($20,000,000) or more in value in the energy sector of Iran; <br />or <br />ii. Contractor, its successor or its affiliate, is a financial institution that extends <br />twenty million dollars ($20,000,000) or more in credit to another person for <br />forty-five (45) days or more, if that person will (i) use the credit to provides <br />goods and services in the energy sector in Iran; and (ii) at the time the <br />financial institution extends credit, is a person identified on list published by <br />the Indiana Department of Administration. <br />4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain any <br />employee or contract with a person that the Contractor subsequently learns is an unauthorized alien. <br />Contractor agrees that he/she/it shall enroll in and verify the work eligibility status of all of Contractor's <br />CITY OF SOUTH BEND <br />STUDEBAKER NATIONAL MUSEUM <br />ROOF RESTORATION AND REPLACEMENT CONTRACTOR'S BID FOR PUBLIC WORKS - 4 <br />
The URL can be used to link to this page
Your browser does not support the video tag.