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NON-CULUSIION AFPPAVrI <br />(Title 23 United States Code Section 112 and <br />Public Contract Coda Section 7106) <br />To the CITY OF SANTA ANA DEPARTMENT OF PUBLIC WORK$ <br />In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the BIDDER declares <br />that tho bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, <br />organ17Aflon, or corporation; that the bid Is genuine and not collusive or sham; that the BIDDER has not directly or <br />indirectly Induced or solicited gay other BIDDER to put in a false or sham bid, and has not directly or indirectly <br />colluded, conspired, connived or agreed with any BIDDER or anyone else to put in a sham bid, or that anyone shall <br />refrain fmm bidding, that the BIDDER has not in any miner, directly or indirectly, sought by agreement, <br />aommunestion, or conference with anyone to fix the bid price of the BIDDER or any BIDDER, or to fix any <br />overhead, profit, or cost element of the bid prlea, or of that of any other BIDDER, or to secure any advantage against <br />the public body awarding the contract of anyone interested In the proposed eoutraot; that all statements contained in <br />the bid are true; and, further, that the BIDDER has not, directly or, indirectly, submitted his or her bid price or any <br />breakdown thereof, or the contents thereof, or divulged Information or data relative tharoto, or paid, and will not pay, <br />any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent <br />thereof to effectuate a collusive or sham bid. <br />Note: The above Non -collusion Affidavit is part of tho Proposal. Signing this Proposal on tho signature <br />Portion thereof shall also consdtuto signaturu of thin Normmllusiuu Affidavit, B11)DERS are eautiunad that <br />making a false Bert tlon nosy subject the ccrtifrar to criminal prosecution <br />6igned <br />State of Saiifernia I"4t>kL'1>A <br />County of L41jkA& I)GH <br />ubbssed d and sworn to (or a$inned) before me on this 57g day of raft* 20g by <br />proved to ane on the basis of satisfactory cvidenca to be the parson(s) who appeared <br />before rne. <br />Notary 1.lublic S1,�/1rat�lu o <br />C.�t-F1'tdW�/3 <br />aAUDIANOSANG <br />i, MY COMMISSION# Go 10n <br />EVIRES:Octaaer 19, 2021 <br />Notary Public Seal <br />City of Santa Ana RFP�* <br />Page A3-1 <br />