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EXHIBIT 4 NON -COLLUSION NON -DEBARMENT AFFIDAVIT NON-IRAN FORM <br />Contractor agrees not to discriminate against or intimidate any employee or applicant for <br />employment in the performance of this contract with privileges of employment, or any matter <br />directly or indirectly related to employment, because of race, religion, color, sex, gender <br />expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of <br />this provision may be regarded as material breach of contract, <br />1, the wiclei-signed bidder or agent as contractor on a public works project, auderstand my <br />statutory obligations to the use of steel products or foundry products made in the United States <br />(1.C. 5-1 b-8-1), 1 hereby certify that i and all subcontractors employed by Me for this project will <br />use steel products or foLmdry products made in the United States on this project if awarded. 1 <br />understand l have an affirmative duty to notify the City in my bid that nay proposal does not <br />include the ttse of steel products or foundry product made in the United States. l understand it is <br />my sole obligation and responsibility to provide a justification to the City, subject to review and <br />approval, why the cost of United States made steel or foundry products is unreasonable, Prior to <br />award and upon submission of bid which does not use steel products or foundry products made <br />in the United States, the City, through its director of public works, shall snake a determination if <br />the price of United States made steel or Foundry is unreasonable. 1 understand that violations <br />hereunder may result in forfciturc of contractual payments. <br />1 hereby affitrn under the penalties of perjury that the facts and information contained in the foregoing bid for <br />public works are true and correct. <br />Datcd this __&�____ day of 04*, 20 0,15 <br />Contractor/Bidder (Firm) <br />srof ontractorlBidder or its Agent <br />�p�g F�uS iSS _N� <br />Printed Name and Title <br />Subscribed and swore to bcforc me this �'"t day of a.. 1 20 <br />My C:ornmission Expires 05 �3`�W NIU& _VU',0V441r, <br />Notary Public <br />�EnVC&4'u1n7lMyAIETS, <br />NaWCounty ofResidenceE_ <br />56 <br />d 41yCvmmisSloilExpSrds <br />M <br />Non-Coliosion Mm-rkbnrnicnl ALTdavil -Non Irim Funu 20 t6 <br />KENNEDY PARK RENOVATION + 24 <br />