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City of Santa Ana <br />Mass <br />Certifications <br />Non -Collusion Affidavit <br />i <br />,•,� � �• ., :GA311i:' ] `• �, :: '^. <br />W) CA—TIMB <br />NDN•t!DLW QN APPMAVIT <br />('line 23 U1114 States Code Section 112 and <br />Public Contract Code S90410117106) <br />To tits MY OF SANTA ANA, D1: PARTMENT OF PUBLIC WURItS <br />In accordance with Iltlo 23 Ullhod status Cods $notion 112 and Public Common Code 7106 die BIDDER <br />that fila bid is not madetndle lntoreat of, or ra bebelfof, any undisalosad lum at, pednwahip, company, ass <br />otganiaadon or oorporadon; that the bid is SenuI4 and not collusive or sham, that thaBBDDLIt has not di <br />Indirectly dnduaod or solloltod any othsr BIDDER to Out in a .lblse or sham bid, and has not dlmutly a, I <br />colluded, eensplrad, connived or agreed with ony BIDDER or anyone else to ptilln a sham bid, or that nay( <br />retiwin from bidding; that hfe p1DPRlt had not In any maano•, dhaaty or Indirectly, sought by eg <br />0ahanadaoflon, or ookferodoD with Anyone to fill the bid prina'af tine BIDDER or any BIDDER, or to <br />ovorhedd, profit, or coal of®meat ofthn.hld price, a• oftilat cf any bUta�Y31DD'RR; orad haama'any xdv6otag� <br />the public bot(y awa@ilug this cannon of anymle ln,dealed In the penposed adlntmot; thxthdl stMomonts cat <br />the bid aro truer and, fnlher, that the BIDDER has 1104, directly or OfIlm tly submitted his or her <br />breakdown thereof, a• the conteptp 111406011, oil divulged Information or data releavo titareto, or paid, <br />tiny fila to any co poratlon, partnership, company 05300latoly orgnolralionr bid depositary, onto may <br />theraorto Wtotuatoa collusive or sham bid, <br />Signed <br />or <br />olned In <br />c or any <br />not pay, <br />Nota 71p above Non-collusldn Affidavit Is pail of 410 PraposaL SignloS tilts Proposal Orville slainta a <br />partial tliainnf shall also cormaltuta elgnahtra of tills Nomcol luslon A'Rida volt. BIDDE118 taro anutiaacd. that <br />makhugafalac�asr410caliarrmay sld,JWt aha aalttler to arhnhmlpraaectitloa. <br />Stale of Califbrnia <br />County of 7 fta C ;�{�4 1�C0•A�fi l c Q�1 t C cV F <br />Subscribed and swou �,ya (a• aned) before ma on Ghia day of 2Q� b <br />preyed to mo on Na birds of emisfaofary avldenac to be 010 pareen(a) who arpagrod <br />Subscribed and <br />Betbra me. <br />Notary Public Signature Notary PmY � ual <br />Dlly ol9anie Ana-RFP— <br />Page AS•t <br />"a g' 31 <br />Comprehensive. Innovative, Trusted. <br />Proposal for O 0all Ettglheering, <br />RFP No. 17.083 <br />