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Exhibit <br />TVI? the prospecti'vie Co n tractor I'S� w ta b le to ciit? to aio; `th �sIcii ienU toiv, it ha11 Me n �)lanal n to <br />F <br />this i <br />CONTRACTOR'S NON -COLLUSION AND NUN -DEBARMENT AFFIDAVIT, CERTIFICATION <br />REGARDING INVESTDZENT WITH IRAN, EMPLOYMENT ELIGIBILITY VERIFICATION, <br />NON-DISCRIMINATION COMMITMENT AND CERTIFICATION OF USE OF UNITED STATES <br />STEEL PRODUCTS OR FOUNDRY PRODUCTS <br />(Must be completed for all quotes and bids. Please type or print) <br />STATE <br />SS: <br />40r° 3 � COUNTY } <br />The undersigned Contractor, being duly sworn upon his/her/Its oath, affirms under the realti s of perjury that <br />Contractor has not, nor has any other mcmber, representative, r agent of the firm, company., <br />corporation or partnership represented by him. entered into any combination, collusion or aorreement with an <br />person relative to the price to be bid by anyone at such letting nor to prevent any Iverson from bidding nor to <br />induce anyone to refrain f of bidding, and that this bid is made witliout reference to any other bid and without <br />any agreement, understanding or combination with any other person 1n reference to such bidding. Contnictor <br />further says that no person or persons, firms, or corporation has, have or will receive directly or indirectly. an <br />rebate, fee, gift, commission or thing of value on account of such sale; and <br />. 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 />aili ipation in this transaction by any Federal department or agency., and <br />. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in investment <br />activities in Iran. <br />a. For purposes of this Certification., .461ranl, mezins the govemment ofIran and any agency or <br />insti-umentality of Iran., or as other -wise defined at Ind. Cody - -�1 . - x as amended fr y tirn - <br />to -tide. <br />b. As provided by Ind. Code § 5-22-16.5-8, as amended from tine -to -time, a Contractor is engaged <br />in investment activities in Iran if either. - <br />Contractor, itS SLIc-cessor or its affiliate, provides goods or services of twenty million <br />dollars($20,000,000)or more in value its the energy sector of Iran; or <br />ii.Contractor� its successor` r its affiliate., i a I inaneia l ' n s tit��ti �� that extends twenty <br />illion dollars , 0,000 or more in credit to another person for forty-five (45) <br />days or more, , ifthat person will i use the credit to provides goods and services in the <br />N. <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 D partnient of Administratioll. <br />. Contractor_ does not knowingly eniployor contract with an tinautliorized alien, nor retain any employee <br />or contract with a person that the onti-act r subseqiendy learns is a ri u ti auth on zed a l i n. Contractor agrees <br />that h /slo it shall enroll in and verify the work eligibility status of all of ontr ct r"s newly hired ei-nployces <br />through the E-Verify Program as defined by I.C. - - I . - i `ontra t is documentation of enr llni nt an <br />participation in the E-Verify Proo-rrn 'is included and attached as part of this bid/quote,- are <br />24 <br />