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DocuSign Envelope ID: 994D7B94-A6E8-44B9-B653-2D49ACC73F7A <br />LAC <br />ATTACHMENT D <br />NON -COLLUSION AFFIDAVIT <br />(Title 23 United States Code Section 112 and Public Contract Code Section 7106) <br />To the CITY OF SANTA ANA <br />In accordance with Title 23 United States Code Section 112 and Public Contract Code 7,106 the proposer <br />declares that the proposal is not made in the interest of, or on behalf of, any undisclosed person, <br />partnership, company, association, organization, or corporation; that the proposal is genuine and not <br />collusive or sham; that the proposer has not directly or indirectly induced or solicited any other proposer <br />to put in a false or sham proposal, and has not directly or indirectly colluded, conspired, connived or <br />agreed with any proposer or anyone else to put in a sham proposal, or that anyone shall refrain from <br />bidding; that the proposer has not in any manner, directly or indirectly, sought by agreement, <br />communication, or conference with anyone to fix the proposal price of the proposer or any proposer, or <br />to fix any overhead, profit, or cost element of the proposal price, or of that of any other proposer, or to <br />secure any advantage against the public body awarding the contract of anyone interested in the <br />proposed contract; that all statements contained in the proposal are true; and, further, that the proposer <br />has not, directly or indirectly, submitted his or her proposal price or any breakdown thereof, or the <br />contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any <br />corporation, partnership, company association, organization, bid depository, or to any member or agent <br />thereof to effectuate a collusive or sham proposal. <br />Note: The above noncollusion affidavit is part of the proposal. Signing this proposal on the signature <br />portion thereof shall also constitute signature of this noncollusion affidavit. Proposers are cautioned that <br />making a false certificatlon may subject the certifier to criminal prosecution. <br />State of California, County of <br />Subscribed and sworn to (or affirmed) before me on this 28 day of May , 2020 , by <br />(y r� S` ae 1 proved to me on the basis of satisfactory evidence to be the person(s) <br />who a peare before me. <br />Notary Puollo . California <br />F ® orango county <br />Commission # 2162557 <br />M comm. Ex Irus Au I3, 20 <br />Notar ublic SINnatfire Notary Public Seal <br />THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. <br />PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. <br />RFP No. 20-053 Video Surveillance System Maintenance and Repair Services Page 38 of 49 <br />25C-40 <br />