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13%en the pro Ap ec6s, e Co n tra dor is unahlc rri certifl+ to Rny nflhe vialem en ts below, it shaI! artiach an explunutiorr tip this Aff'60vi4 <br />CONTRACTOR'S NON-COI-,LUSION AND NON, -.DEBARMENT AFFIDAVIT, <br />CERTIFICATION REGARDING INVESTMENT WITH I RAN, EMPLOYMENT E I -, I GIBILITY <br />VERIFICATION, NOK-DISCRIMINATION COMMITMENT AND CERTIFICA7'ION OF USE <br />01L'UNITED STATES STEEL PRODUCTS OR FOUNDRY PRODUCTS <br />(Must be completed for al I quotes and bids. P(ease type or prfP <br />i nth <br />STATE. OF_ .IL-gr� � <br />SS: <br />COUNTY <br />'nte undersigned Contmaor, bein <br />g d u 131 swom upon hi'slh e r/its oath, aff rms under the penalties of pe d ury that: <br />1. Contractor has not, nor has any other member, representative, or agent of the firm, <br />company.rorporation or partnership represented by him, entered into any combination, collusion <br />or agreement with any person relative to the price to be bid by anyone at such lettina nor to <br />pre�.,ent any person from bidding nor to induce anyone to zefrain from bi dding, and that this bi d <br />is made without reference to any other bid and without any agreement, understanding or <br />combination with any other person in reference to such bidding. Contractor further says 'that no <br />person or persons, firms, or corporation has, have or will receive directly or indirectly, any <br />rebate, fee, gift, commission or thing of value on account of such sale; and <br />2. Contractor certifies by submission of this proposal that neither contractor nor any of its <br />principals are presently debarred, suspended, proposed for debarment, declared ineligible, or <br />voluntarily excluded from participation in this transaction by any Federal department or a��encv; <br />and Y <br />Contractor has not, nor has anv successor t, nor an affili'ate of, Contractor; cngaged in <br />investment activities in Iran* <br />a. For p��rposcs of this Certification, '`Iran" means the govemment of Iran and any agency or <br />ins�rumentalin• of Iran, or as other��ise defined a� Ind. Code � �-22-�G.�-�, as amended from <br />thne-to-time_ <br />b. As provided b-v Lid. Cade § 5-22-16.5-8,as amended from time -to -time, a Contractor is <br />engaged in investment activiffies in bran if either: <br />i. Contractor., its successor or its affiliate, provides loads or services �f t���enty �tt�ilion <br />dollars ($20,000,000) or more in value in the energy sector of bran; or <br />ii. Contractor, its successor or its �Iiate, is a fiaanciai institution that extends ri��enri� <br />million dollars ($20,000,000) or more in credit to anoth�:r persL)n for forty-five (45) <br />9' <br />days or more ifthat person will (i} use the credit to provides goads and services in <br />ir <br />T -00jlus * Qn Nce-DvI)ament Affidavit Non Irmt Form tdo <br />