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CITY OF SANTA ANA <br />PROPOSAL <br />NO.20-2714: EL SALVADOR PARK BASKETBALL COURT AND COURT LIGHTING <br />NO.20-2717: RIVERVIEW PARK BALLFIELD SPORTS LIGHTING <br />NON -COLLUSION AFFIDAVIT <br />(Title 23 United States Code Section 112 and Public Contract Code Section 7106) <br />In conformance with Title 23 United States Code Section 112 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 bid 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 />conspired, 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 />true; and, further, that the BIDDER has not, directly or indirectly, submitted his or her bid price <br />or any 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 Non -collusion Affidavit is part of the Proposal. BIDDERS are <br />cautioned that making a false certification may subject the certifier to criminal <br />Signed <br />State of California <br />County of Orange <br />Subscribed and sworn to (or affirmed) before me on this 5 fit day of May 2021'by <br />proved to me on the basis of satisfactory evidence to be the <br />person(s) who appeared before me <br />&-Q_ V <br />Notary Public Signature Notary Public Seal <br />Lotary public or other officer completing this certificate verifies only the <br />tity of the individual who signed the document to which this certi:icate <br />ttached, and not the truthfulness, accuracy, or validity of that document. <br />State of CalifjKrua <br />County of Uvla4.0421 1_ <br />Subs�c/rrii/b�ed� and,, sworn to (--7yaf��firmed —before me on this V` day <br />of , 20dL, byMa —L �I <br />ai) M k i Q Y , proved to me on the basis <br />of satisfactory eviden a to be the ersrofn(s wh,onppeared before me. <br />Signature A .t Q y YJy�' <br />P-11 of P-17 <br />RARI L. HALVERSON <br />Notary Public - California L. <br />} c Orange County — <br />Commlaaan # 2121176 <br />My Comm. Expires Feb 11, 2024 <br />