Opening of Bids - Spec S - One or More 2018 or Newer Emergency Medical Vehicle - Horton Emergency Vehicle - Part 1

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Comprehensive Compliance Form (CCF) for Bid on Ambulance NON-DISCRIMINATION Contractor, subcontractor, and bidder declare that they will not discriminate against any employee or applicant for employment in the performance of this contract with respect to hire, tenure, terms, conditions or privileges of employment, or any matter indirectly related to employment because of race, religion, color, sex, disability, national origin or ancestry. Contractor, subcontractor and bidder shall comply with this declaration, and understand that breach of this covenant may be considered a material breach of contract. DISQUALIFICATION OF CONTRACTS DEALING WITH THE GOVERNMENT OF IRAN The undersigned does hereby certify that the person and/or business entity contracting herein has never and currently does not contract with the government of Iran for such business and services as defined in I.C. 5-22-16.5-1 et. seq. Furthermore, the undersigned will take the necessary steps to maintain compliance with this statutory provision throughout the term of this agreement, Failure to comply with this statutory section may result in termination of this agreement. DRUG FREE WORKPLACE Any and all contractors performing work for the Town of New Carlisle shall maintain a drug free work place pursuant to applicable federal and state law regulations. By contracting with the Town of New Carlisle, each contractor hereby certifies and agrees that it will provide a drug free workplace and take all appropriate steps to insure that all applicable federal and state regulations concerning the implementation of such drug free workplace has occurred. OSHA AND IOSHA REGULATIONS It is the policy of the Town of New Carlisle to be in compliance with all federal and state occupational safety and health regulations and/or standards. It is a requirement for any person, company or corporation doing business with the Town of New Cal -lisle to be in compliance with the appropriate OSHA and IOSHA regulations and/or standards. Any person, company or corporation not in compliance shall hold the Town of New Carlisle harmless from any and all injuries, illness and death arising out of non-compliance with the OSHA and IOSHA regulations and/or standards and such non-compliance shall be considered in material breach of any contractual agreement with the Town of New Carlisle, Contractor, subcontractor and bidder shall comply with OSHA and IOSHA regulations and understands that breach of this covenant may be considered a material breach of the contract. EMPLOYMENT ELIGIBILITY VERIFICATION PURSUANT TO I.C. 22-5-1.7 el. seq. The undersigned hereby affirms under the penalties of perjury that they do not knowingly employ or contract with an unauthorized alien. Furthermore, the Contractor shall enroll in and verify (or has enrolled in and verified) the work eligibility status of all of its newly hired employees through the E-Verity program as defined in I.C. 22-5-1,7-3, The Contractor is not required to participate should the E-Verify program cease to exist. Additionally, the Contractor is not required to participate if the Contractor is self- employed and does not employ any employees. The Contractor shall not knowingly employ or contract with an unauthorized alien. The Conti -actor shall require its subcontractors, who perform work under this contract, to certify to the Contractor that the subcontractor does not knowingly employ or contract with an unauthorized alien. The Contractor shall not retain an employee or contract with a person a Contractor subsequently learns is an unauthorized alien, The Contractor shall require its subcontractors, who perform work under this contract, to certify to the Contractor that the subcontractor does not knowing employ or contract with an unauthorized alien and that the subcontractor has em-olled in and is participating in the E-Verify program. The Contractor agrees to maintain this certification throughout the duration of the term of a contract with the subcontractor. The Town may terminate this Agreement for breach of contract/default if the Conti -actor fails to cure a breach of this provision no later than thirty (30) days after being notified of such breach, The undersigned hereby acknowledges, certifies and affirms the above provisions, and agrees that if awarded the contract for the above named project, said provisions will be attached to and incorporated into the fin contract. tract. DESTANIE N. STOUT "IE Company Name: HORTON AMBULANCE STATE OF OHIO Seal SS: contract. Public - State of Indiana c St Joseph Company Address.3800 MCDOWELL ROAD COUNTY OF FRANKLIN My Commission County ssi My Commission Fxpires 0o 28 2024 ore me this f 120 Subscribed and sworn to before day o A44,114 25'1 By (Signature) My commission expires: 12 -JL62'1 Printed Name: ROBERT W BURGH Signed: Title: SALES MANAGER Residing in ST. Jounty' State of INDIANA Date:- 1911116