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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 17-6894 <br />EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION <br />FEDERAL PROJECT NO: HSIPL 5063 (171) <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 and <br />not collusive or sham; that the BIDDER has not directly or indirectly induced or solicited any other <br />BIDDER to put in a false or sham bid, and has not directly or indirectly colluded, conspired, <br />connived, or agreed with any BIDDER or anyone else to put in a sham bid, or that anyone shall <br />refrain from bidding; that the BIDDER has not in any manner, directly or indirectly, sought by <br />agreement, communication, or conference with anyone to fix the bid price of the BIDDER or any <br />other BIDDER, or to fix any overhead, profit, or cost element of the bid price, or of that of any <br />other BIDDER, or to secure any advantage against the public body awarding the contract of anyone <br />interested in the proposed contract; that all statements contained in the bid are true; and, further, <br />that the BIDDER has not, directly or indirectly, submitted his or her bid price or any breakdown <br />thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will <br />not pay, any fee to any corporation, panne hip, company association, organization, bid <br />depository, or to any member or agent thereof t�ffectuate a collusive or sham bid. <br />Note: The above Non llu i it is part of the Proposal. BIDDERS are cautioned <br />that making a f its le c r m y subject the certifier to criminal prosecution. <br />Signed <br />State of C ifornr I <br />County of�Lgs�Q�Q, <br />ubscribed and orn(}}to (or affirmed) before me on this2l day of ()Z 202, by <br />proved to me on the basis of satisfactory evidence to be the person(s) <br />who a0pearea before me <br />:� Cindi Esmeralda Santamaria Castillo <br />_ Comm. fl2200339 p <br />'�;i_ ,� '''.'�� � Notary Pu61ic California o <br />s Los Angeles County <br />�,, hfy Comm. Expires June 5, 2021 <br />a Public Signature Notary Public Seal <br />P-12 ofP-39 <br />