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FULL AGENDA PACKET_2021-04-20
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FULL AGENDA PACKET_2021-04-20
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City Clerk
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Agenda Packet
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Clerk of the Council
Date
4/20/2021
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ATTACHMENT 3-1, NON -COLLUSION AFFIDAVIT <br />CERTIFICATIONS <br />NON -COLLUSION AFFIDAVIT <br />(Title 23 United States Code Section 112 and <br />Public Contract Code Section 7106) <br />To the CITY OF SANTA ANA DEPARTMENT OF PUBLIC WORKS <br />hh accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the IIIDDP�R declares <br />that the bid is not made in the interest of, of on behalf of, any undisclosed person, partnership, company, association, <br />organization, or corporation; that the bid is genuine and not collusive or sham; that the BIDDER has not directly or <br />indirectly induced or solicited any other BIDDER to put in a false or sham bid, and has not directly or indirectly <br />colluded, conspired, 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 agreement, <br />communication, or conference with anyone to fix the bid price of the BIDDER or any BIDDER, or to fix any <br />ovei head, profit, or cost element of the bid price, or of that of any other BIDDER, or to secure any advantage against <br />the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in <br />the bid are true; and, further, that the BUDDER has not, directly or indirectly, submitted his or her bid price or any <br />breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, <br />any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent <br />thercof to effectuate a collusive or sham bid. <br />Note: The above Non -collusion Affidavit is part of the Proposal. Signing this Proposal on the signature <br />portion thereof shall also constitute signature of this Non -collusion Affidavit. BIDDERS are cautioned that <br />making a false (;ci - •ation may subject the certificr to criminal prosecution. <br />Signed <br />T I �n. n .. <br />State of eahfermia P '.n s a <br />County of, ....Pjt." U, 4Cz11, h ; a <br />Subscribed and sworn to (or affirmed) before me on this Y.` day of lY(ce,z�, 20,E by <br />roved to me on the basis of stuisfauo evidence p satisfactory dence to be the person(s) who appeared <br />before me. <br />Notary Public Signature <br />Lormton«eafth Of P¢na,yt,aIfa Notary Scni jjj� <br />f(AhEN E_ i tt, Notary Pubrlc -•� <br />Phfladotllfl�olpnfd Caurty <br />My CtMLhtl5 iOn EAPfr4 Atnt 27, 74�X4 <br />C=MiSS W NomLwY Q0693A <br />Notary Public Seal <br /> <br />(iry Council <br /> :24 tndash;&nhsp;25 <br />4/20/2021 <br />&II)Sp; <br />
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