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orientation, handicap, national origin or ancestry. Breach of this provision may be regarded as material breach of contract. I, the undersigned bidder or agent as contractor on a public works project, understand my statutory obligations to the use of steel products or foundry products made in the United States (I.C. 5-16-8-1). 1 hereby certify that I and all subcontractors employed by me for this project will use steel products or foundry products made in the United States on this project if awarded. I understand I have an affirmative duty to notify the City in my bid that my proposal does not include the use of steel products or foundry products made in the United States. I understand it is my sole obligation and responsibility to provide a justification to the City, subject to review and approval, why the cost of United States made steel or foundry products is unreasonable. Prior to award and upon submission of bid which does not use steel products or foundry products made in the United States, the City, through its director of public works, shall make a determination if the price of United States made steel or foundry is unreasonable. I understand that violations hereunder may result in forfeiture of contractual payments. wr• I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid for public works are true and correct. Dated this 9ifi- day of At .&017 �00-t—H som RY 1 GG� Contractor/Bidder (Firm) Signature of Contractor/Bidder or Its Agent 5&77- eQb7Z� eNi&For- ftfCA6 Printed Name and Title Subscribed and sworn to before me this 914K day of , 20.C4? My Commission Expires CQ77f� Notary Public County of Residence DAWN R. EBERSOLE Notary Public, state of Indiana aOGRv, Laporte County SEA f .` Commission 8 644840 %y .,..•� My Commission Expires 811110 June 01,2021 Non -Collusion Non -Debarment Affidavit Non Iran Form 2016