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Appendix v <br />ATTACTIM NT 3-1: NON -COLLUSION AFFIDAVIT <br />CERTIFICATIONS <br />NON -COLLUSION AFFIDAVIT <br />(Title 23 United States Code Section 112 and <br />Public Contract Code Section 7106) <br />'Co the ary of SANTA ANA DEPARTMENT OFPUBLIC WORKS <br />In accordance with 'If le 23 United States Code Section 112 and Public Contract Code 7106 the BIDDER declares <br />that the bid is not made in the interest of, or on behalf of, any undisclosed' person, Partnership, company, association, <br />organization, or corporation; that the bid is genuine and not collusive or sham; that the BIDDER has not directly or <br />indirectly induced or solicited any 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 pat in a sham bid, or that anyone shall <br />refrain from bidding; that the BIDDER has not in any manner, dirwly or indirectly, sought by agreement, <br />communication, 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 price, 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 contract; 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 thereto, 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: 'llie above Non -collusion Affidavit is 'part of the Proposal. Sighing this Proposal on the signature <br />portion thereof shall also continue signature of this Non -collusion Affidavit. BIDDERS are cautioned that <br />making a false certification may subject the certifier to criminal prosecution. <br />Signed /Z 1 T r <br />State of California <br />County ofJa n_J1zCnaf a1 n ka <br />Subscribed and sworn to (or affirmed) before me on this [ 7 day of fha201P_, by <br />. proved to me on the basis of satisfactory evidence to be the petsan(s) rxfro appeared <br />before Inc. <br />Notary Public Signature <br />IwAwANrsrwAw-- <br />'THERESA L..ESA EASTEH - <br />J <br />COMM. # M2H9 E <br />M. NOTA"PUanO-CAnFONNUK <br />8N19ENNM&::f0U" <br />*Cm Fxpkft r46, 2, 202Y <br />Notary Public Seal <br />City of Santa Ana RFP <br />Page A3-1 <br />