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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 15-6446 <br />SAINT GERTRUDE AND BRAND AVENUE WATER MAIN REPLACEMENT <br />NON•COLL,�{�g,ION Al+ IDF AViT <br />(Title 23 United States Code Section 112 and Public Contract Code Section 7106) <br />In conformance with Title 23 United States Code Section I I2: 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 laid 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 />conspucd, 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 />trite; and, further, that the BIDDER has not, directly or indirectly, submitted his or her bid price <br />or tiny 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 Nan -collusion Affidavit is part of the Proposal. BIDDERS are <br />cautioned that making a false certification may subject the certifier to criminal <br />prosecution. <br />Signed Apq§Nto R-AM i i? VZ <br />State of Cal fomia <br />County of wri <br />Subscribed and sworn to (or affirmed) before me on this 5 day of 20,E by <br />wL�Wm ")z= - , proved to me on the basis of satisfactory evidence to be the <br />person*who appeared before me <br />E/ <br />ry Public Signature Notary Public Seal <br />dAV1eR WTR04oNZI .t•2 <br />t oommbdon No. 9201480 <br />NOMarfUklb, M O"A <br />amsssaecocmw j <br />raan.cw«wutGi �r,'�iZ? <br />P•13 of P•19 <br />