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23A - NEW PARK AT 6TH & LACY
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03/05/2019
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23A - NEW PARK AT 6TH & LACY
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Last modified
2/28/2019 7:30:27 AM
Creation date
2/28/2019 7:25:13 AM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
3/5/2019
Destruction Year
2024
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A notary public or other officer coinpletin6this <br />certificate verifies only the identity of the indi- CITY OF SANTA ANA <br />vidual who signed the document to which this PROPOSAL <br />certificate is attached, and not the truthfulness. <br />accuracy, or validity of that document. PROJECT NO.: 18-2692 <br />NEW PARK AT 6TH AND LACY STREET <br />NON -COLLUSION AFFIDAVIT <br />(Title 23 United States Code Section 112 and Public Contract Code Section 7106) <br />In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the <br />BIDDER declares that the bid is not made in the interest of, or on behalf of, any undisclosed <br />person, partnership, company, association, organization, or corporation; that the bid is genuine <br />and not collusive or sham; that the BIDDER has not directly or indirectly induced or solicited <br />any other BIDDER to put in a false or sham bid, and has not directly or indirectly colluded, <br />conspired, connived, or agreed with any BIDDER or anyone else to put in a sham bid, or that <br />anyone shall refrain from bidding; that the BIDDER has not in any manner, directly or indirectly, <br />sought by agreement, communication, or conference with anyone to fix the bid price of the <br />BIDDER or any other BIDDER, or to fix any overhead, profit, or cost element of the bid price, <br />or of that of any other BIDDER, or to secure any advantage against the public body awarding the <br />contract of anyone interested in the proposed contract; that all statements contained in the bid are <br />true; and, further, that the BIDDER has not, directly or indirectly, submitted his or her bid price <br />or any breakdown thereof, or the contents thereof, or divulged information or data relative <br />thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, <br />organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham <br />bid. <br />Note: The above Non -collusion Affidavit is part of the Proposal. BIDDERS are <br />cautioned that making a false certification may subject the certifier to criminal <br />orosecution. <br />Signed <br />State of California <br />County of 41S AMA, et S <br />Subscribed arld sworn to (or affirmed) before me on this _a day of 5,g2v, 20_by <br />j proved to me on the basis of satisfactory evidence to be the <br />persona) who appeared before me <br />Notary Public Seal <br />JOSHUA JAMES SPENCER <br />Commission No.2133971 <br />z a`t m NOTARY PUBLIC -CALIFORNIA <br />LOS ANGELES COUNTY <br />My Com. Expires NOVEMBER 15, 2019 <br />23"1318 <br />
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