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Exhibit H <br />II'hen the prospective Contractor is unable to cert� to any of the statements below, it shall attach an zrplrrnation to <br />this Afrlavit. <br />CONTRACTOR'S NON -COLLUSION AND NON-DEBARPrIENT AFFIDAVIT, CERTIFICATION <br />REGARDING INVESTMENT WITH IRAN, EMPLOYMENT ELIGIBILITY VERIFICATION, <br />NON-DISCRIMINATION COMMITMENT AND CERTIFICATION OF USE OF UNITED STATES <br />STEEL PRODUCTS OR FOUNDRY FRODUCTS <br />(Must be completed for all quotes and bids. Please type or print) <br />STATE OF `Srritatva ) <br />) SS: <br />•D1� COUNTY ) <br />The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury 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 any <br />person relative to the price to be bid by anyone at such letting nor to prevent any person from bidding nor to <br />educe anyone to refrain from bidding, and that this bid is made without reference to any other bid and without <br />any agreement, 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 or indirectly, any <br />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 are <br />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 <br />any successor to, or an affiliate of, <br />Contractor, <br />engaged in investment <br />activities in Iran. <br />a. For purposes of this Certification, "Iran" means the government of Iran and any agency or <br />instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as amended from time - <br />to -time. <br />b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor is engaged <br />in investnent activities in Iran if either: <br />i. Contractor, its successor or its affiliate, provides goods or services of twenty million <br />dollars ($20,OOQ000) or more in value in the energy sector of Iran; or <br />ii. Contractor, its successor or its affiliate, is a financial institution that extends twenty <br />million dollars ($20,000,000) or more iu credit to another person for forty-five (45) <br />days or more, if that person will (i) use the credit to provides goods and services in the <br />energy sector in Iran; and (ii) at the time the financial institution extends credit, is a <br />person identified on list published by the Indiana Department of Administration. <br />4. Coou'actor does not knowingly employ or contract with all unauthorized alien, nor retain any employee <br />or contract with a person that the Contractor subsequently learns is an unauthorized alien. Contractor agrees <br />that he/slie/it shall enroll in and verify the work eligibility status of all of Contractor's newly hired employees <br />through the E-Verify Program as defined by I.C. 22-5-1.7-3. Contractor's documentation of enrollment and <br />participation in the E-Verify Program is included and attached as part of this bid/quote; and <br />24 <br />