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25G - AGMT METER INFRASTRUCTURE
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05/07/2019
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25G - AGMT METER INFRASTRUCTURE
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Last modified
5/2/2019 6:17:26 PM
Creation date
5/2/2019 6:03:20 PM
Metadata
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
25G
Date
5/7/2019
Destruction Year
2024
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NON -COLLUSION AFFIDAVIT <br />(Title 23 United Stales 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 BIDDER <br />declares that the bid is not made in the interest of, or on behalf of', any undisclosed person, partnership, <br />company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the <br />BIDDER has not directly or indirectly induced or solicited tory other BIDDER to put in a false or sham bid, and <br />has not directly or indirectly colluded, conspired, connived, or agreed with any BIDDER or anyone else to put <br />in a sham bid, or that anyone shall refrain from bidding: that the BIDDER has not in any manner, directly or <br />indirectly, Sought by agreement, communication, or conference with anyone to Fix the bid price of the BIDDER <br />or any other BIDDER, or to fix any overhead, profit, or cost element of the bid price, or of that of any other <br />BIDDER. or to secure any advantage against the public body awarding the contract of anyone interested in the <br />proposed contract; that all statements contained in the bid are true; and, further, that the BIDDER has not, <br />directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or <br />divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, <br />company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive <br />or sham bid. <br />Note: The above Non -collusion Affidavit is par of the Proposal. BIDDERS are cautioned that making <br />a false certification may subject the certifier to criminal prosecution. <br />Signed <br />/n7 State ofC-aliSariia,LO1ti516AQ' <br />/'arrSj) C-etmlyoI`LAS ? _[-pn pot 43t <br />Subscribed .and sworn to . (or affirmed): before me on this. day of20(9, by <br />%l%12t7(C 0,01 Pin proved to me on the basis of satisfactory evidence to be the person(s) who <br />appeared before me <br />/ o w Q� Q/f7TJ%^t' Q TJ �+-C/1.cP.��v <br />N Public Signahrre #"V751 Notary Public Sea] <br />City of Santa Ana RFP 18-064 <br />Page 31 <br />oze of <br />H IT -151 <br />
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