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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 />I, the undersigned bidder or agent as contractor on a public works project, understand my <br />statutory obligations to the use of steel products or foundry products made in the United States <br />(I.C. 5-16-8-1). I hereby certify that I and all subcontractors employed by me for this project will <br />use steel products or foundry products on this project if awarded. I understand that violations <br />hereunder may result in forfeiture of contractual payments. <br />I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid for <br />public works are true and correct. <br />Dated this day of MOib <br />Contractor/Bidder (Firm) <br />Signature of Contractor/Bidder or Its Agent <br />Printed Name and Title <br />Subscribed and sworn to before me this � day of � RIMCkr20 6 <br />My Commission Expires O IY�t_ �� ap 17 , Q, , l x r\"�Ip a'� <br />Notary Public U <br />County of Residence f)cn�r'k �yC h <br />;,.w���eo�,, <br />rCmpber.ly4i���A{{./ryVBodeil <br />Yl� YCI�9i <br />2 c+: SEN, rt <br />ry RBJ���aG��l V1 <br />�. JOSfph COIRIty <br />�:,.-` <br />MYCommt+sionE res: <br />4nU� <br />to/ptiGytl <br />�M/VyV V <br />Von -Collusion Non-Debannent Affidavit Non Iran Form <br />