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EXHIBIT D <br />APPENDIX <br />ATTACHMENT 3-1: NON -COLLUSION AFFIDAVIT <br />CERTIFICATIONS <br />CITY OF SANTA ANA <br />REQUEST FOR PROPOSALS <br />FOR <br />REVIVE: <br />SANTA ANA FOOD SUPPLY/DISTRIBUTION PROGRAMS <br />RFP NO.: 22.009A <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 CITY MANAGER'S OFFICE <br />In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the BIDDER declares <br />that the bid is not made in the interest of, or 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 cr 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 overhead, <br />profit, or cost element of the bid price, or of that of any other BIDDER, or to secure any advantage against the public <br />body awarding the contract of anyone interested in the proposed contract; that all statements contained In the bid <br />are true; and, further, that the BIDDER has not, directly or indirectly, submitted his or her bid price or any breakdown <br />thereof, or the contents thereof, or divulged Information or data relative thereto, or paid, and will not pay, any fee to <br />any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof <br />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 portion <br />thereof shall also constitute signature of this Non -collusion Affidavit. BIDDERS are cautioned that making a <br />false certification may subject the certifier to criminal prosecution. <br />Organization VGlr11 <br />Signed and Printed Name: <br />Title,iG"GIj61Q l�lri <br />Date '/Y! 7, 1 U� <br />City of Santa Ana RFP 22-009A <br />Page 42 <br />A <br />