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CITY OF SANTA ANA L:: ATTACHMENT C NON -COLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) T6 the CITY OF SANTA ANA In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the Respondent declares that the statement of qualificationsis not made In the Interest of, or an behalf of, any undisclosed person, partnership, company, association, organization. or corporation; that the statement of qualificationsis genuine and not collusive or sham; that the Respondent has not directly or indirectly induced or solicited any other Respondent to put in a false or Rham statement of qualification, and has not directly or indirectly colluded, conspired, connived or agreed with any Respondent or anyone else to put in a sham statement of qualification, or that anyone shall refrain from bidding; that the Respondent has not in any manner, directly or Indirectly, sought by agreement, communication, or conference with anyone to fix the statement of qualdlcationsprioe of the Respondent or any Respondent, or to fix any overhead, profit, or cost element of the statement of qualificationsprice, or of that of any other Respondent, or to secure any advantage against the public body awarding the contract of anyone interested In the proposed contract: that all statements contained fir thu slaleolent of qualificHijunsare true; and, further, that the Respondent has not, directly or indirectly, submitted his or her statement of qualificatlonsprice or any breakdown thereof, or the contents thereof, or divulged information or data relative therein, or pald, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham statement of qualification. Note: The above noncollusion affidavit is part of the statement of qualification. Signing this statement of qualificationson the signature portion thereof shall also constitute signature of this noncollusion affidavit. Respondents ar cautioned that making a false certification may subject me certifier to criminal prosecution. / � , State of California, Colty of v l/0,(�Rf _ Subscribed and sworn to (or affirmed) before me on this lit day of ViO Q 20 'Z k by who appeared before me, proved to me on the basis of satisfactory evidence to be thp person($) 4aY1N:✓• RASE CNKLIN aOliR 4 2272aaa NDTNRY U.'I'CAnPORNIA 0 TJ ORANGE COUNTY E,.ns DES[WfR N. tW7 4. Nd tic Signature Notary Public Seal THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE STATEMENT OF QUALIFICATIONS. STATEMENT OF QUALIFICATIONS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED . NONRESPONSIVE. RFb No. 21-016 State Legislative Advocacy Services Page 26 of 29 Q Statement of Qualifications for State Legislative Advocacy Services I City of Santa Ana Page 24