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BELOW <br />\u SUBSURFACE IMAGING <br />Appendix <br />ATTACHMENT 5-1; NON -COLLUSION <br />NON -COLLUSION AFFIDAVIT <br />('Iltte23 United States Code Section I t2and <br />Public Contact Code Section 7106) <br />14280 Euclid Ave <br />Chino, CA 91710 <br />1-888-90-BELOW <br />Certified SBE <br />4X CERTIFICATIONS <br />To the CITY OF SANfA AN,A DEPAR-1'MEN'F OF Pt AIIAC WORKS <br />In accordance with Title 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 an behalf of, any undisclosed person, partnership, company, association, <br />organization, w corporation; that the bid is Violas and not collusive or sham; that the BIDDER has not directly er <br />odimctly induced to solicited airy other BIDDRR to put in a false or sham bid, and has not directly or hldimedy <br />colluded, conspired, connived or agreed with any BIDDER. or anyone else to put in it sham bid, or that anyone shall <br />refrain from bidding; that the BIDDER has not In any manner, directly or indiroctly, sought by agreement, <br />communication. or conference with anyone to fix the bid price of the BIDDER or any BIDDER, or io E. any <br />overhead, profit or cost element of the bid price, or of that of any other BIDDER, or to secure any adwntage against <br />the public body awarding the contract of anyone interested in the proposed contract; that all shipments contained in <br />the bid arc muc; and, (umber, that the R1DDF.R her not, directly or indirectly, submitted his or her bid (Rice or any <br />breakdown thereof, or the contains thereof, or divulged information or data relative thereto, or paid, and will not pay, <br />any fee to my contomtion, partnerhip, company association, organuattion, bid depository, or to any nremher or agent <br />thercoNa effectuate a uotlusn,v or sham bid. <br />Note: The above Nun -collusion Affidavit is pact of the Proposal. Signing this Proposat on the signature <br />portion thereof shall also constitute signature of this Non -collusion Affidavit BIDDERS are cautioned that <br />mnkinga false oerliBeaQon may subject the card Fier to criminal prosecution. <br />Signed <br />State ofCalifonda <br />County of�tan (hPfnea-drrap <br />lt'c-bed and &wore to (or affirmed) befam me on this Alin day of _ 2f X) by <br />L I proved to me on the basis of satisfactory eridenec to be the perms 1 whu apprarc l <br />Ixdbra m <br />LINGSEY ME SMIt <br />^ C6YY.�!!!10lS <br />a, aim <br />_ cow.rwr.rxaPw UI <br />'1tydtlL pith i -no. Notary Public Seal <br />City of Santa Ana RFP 20-060 <br />Page A5-i <br />RFP No. 20-060 Subsurface Utility Engineering Services <br />www.cbelow.com Page 12 <br />*0 <br />25D-94 <br />