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"The vendor hereby agrees, pursuant to the provisions of Section 103-a of the General Municipal Law, which requires that upon refusal of a person when called before a Grand Jury, Head of a State agency, the Organized Crime Task Force in the Department of Law, head of a City Department, or other City agency, which is empowered to compel the attendance of witnesses and examine them under oath to testify in an investigation concerning any transaction or contract had with the state, any political subdivision thereof, public authority or with any public department, agency, or official of the State or of any political subdivision thereof or of a public authority, to sign a waiver of immunity against subsequent criminal prosecution or to answer any relevant question concerning such transaction or contract. (a) Such person, any firm, partnership, or corporation of which he is a member, partner, director or officer shall be disqualified from thereafter selling to or submitting bids to or receiving awards from or entering into any contracts with any municipal corporation or fire district, or any public department, agency or official thereof, for goods, work or services, for a period of five years after such refusal, and to provide also that (b) Any and all contracts made with any municipal corporation or any public department, agency or official thereof on or after the first day of July 1959, or with any fire district or any agency or official thereof on or after the first day of September, 1960, by such person, and by any firm, partnership or corporation of which he is a member, partner, director or officer may be cancelled or terminated by the municipal corporation or fire district without incurring any penalty or damages on account of such cancellation or termination, but any monies owing by the municipal corporation or fire district for goods delivered or work done prior to the cancellation or termination shall be paid." Company: __________________________________ __________________________________ Signed By: __________________________________ Title: __________________________________ DATE: _________________________