Will this bumper fit if I'm running aftermarket fog lights?

Yes. Since this cover doesn't have fog light cutouts, you can mount aftermarket fogs separately below the bumper or integrate them into your custom setup. You'll have full control over the lower fascia layout.

Does this bolt directly to the truck, or do I need to remove my old bumper first?

You'll need to remove the factory bumper to install this one. It mounts at the factory points, so no drilling or frame modification is required—just unbolt the old one and bolt this in its place.

What should I do before painting?

The primed surface is ready for standard automotive paint prep. Light sand, clean, and apply your base coat and clear. If you're leaving it primed, seal it to prevent UV degradation.