REF'PESENTAT I ON: The unders i gned bidder represen ts k appropr iate boxes) lhat the bidder, I ts of f i cers or agents ( ) have ( ) have no t refused to furnish upon request the refor, information or r o c ords ot any Government or an y establishment in the legislative or Judi d al bran' : h ot the Government wIth respec t to an y contract with an y department, agency, or other Instrumentality