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9 <br /> <br /> <br />CITY OF SOUTH BEND, INDIANA <br />SELLER’S BID FOR SALE OR LEASE OF MATERIALS <br />AND NON-COLLUSION AND NON-DEBARMENT AFFIDAVIT AND <br />NON-DISCRIMINATION COMMITMENT FOR SELLERS <br /> <br />BID NAME Spec A – One (1) or More 2023 or Newer Self-Propelled Spreader <br />FOR BIDS DUE March 12, 2024; 9:00 a.m. <br /> <br />Date: <br />Bidder <br />March 8, 2024 (Firm): Oxbo International l Corp <br /> <br /> <br />Address: 10605 West 750 N <br />City/State/Zip: Shipshewana IN 46565 Telephone Number: (260) 768-3217 <br />Agent of Bidder (if Applicable): <br /> <br />When the prospective Contractor is unable to certify to any of the statements below, it shall attach an explanation to this Affidavit. <br /> <br />CONTRACTOR’S NON-COLLUSION AND NON-DEBARMENT AFFIDAVIT, <br />CERTIFICATION REGARDING INVESTMENT WITH IRAN, EMPLOYMENT ELIGIBILITY <br />VERIFICATION, NON-DISCRIMINATION COMMITMENT AND CERTIFICATION OF <br />USE OF UNITED STATES STEEL PRODUCTS OR FOUNDRY PRODUCTS <br /> <br />(Must be completed for all quotes and bids. Please type or print) <br /> <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 /> <br />1. Contractor has not, nor has any other member, representative, or agent of the firm, <br />company, corporation or partnership represented by him, entered into any combination, <br />collusion or agreement with any person relative to the price to be bid by anyone at s uch <br />letting nor to prevent any person from bidding nor to induce anyone to refrain from bidding, <br />and that this bid is made without reference to any other bid and without any agreement, <br />understanding or combination with any other person in reference to such bidding. Contractor <br />further says that no person or persons, firms, or corporation has, have or will receive directly <br />or indirectly, any rebate, fee, gift, commission or thing of value on account of such sale; and <br /> <br />2. Contractor certifies by submission of this proposal that neither contractor nor any of <br />its principals are presently debarred, suspended, proposed for debarment, declared ineligible, <br />or voluntarily excluded from participation in this transaction by any Federal department or <br />agency; and