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APPENDIX <br /> ATTACHMENT 5: CERTIFICATIONS <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 <br /> 7106 the BIDDER declares that the bid is not made in the interest of, or on behalf of, any <br /> undisclosed person, partnership, company, association, organization, or corporation; that <br /> the bid is genuine and not collusive or sham; that the BIDDER has not directly or indirectly <br /> induced or solicited any other BIDDER to put in a false or sham bid, and has not directly <br /> or indirectly colluded, conspired, connived, or agreed with any BIDDER or anyone else to <br /> put in a sham bid, or that anyone shall refrain from bidding; that the BIDDER has not in <br /> any manner, directly or indirectly, sought by agreement, communication, or conference <br /> with anyone to fix the bid price of the BIDDER or any other BIDDER, or to fix any <br /> overhead, profit, or cost element of the bid price, or of that of any other BIDDER, or to <br /> secure any advantage against the public body awarding the contract of anyone interested <br /> in the proposed contract; that all statements contained in the bid are true; and, further, <br /> that the BIDDER 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 <br /> thereto, or paid, and will not pay, any fee to any corporation, partnership, company <br /> association, organization, bid depository, or to any member or agent thereof to effectuate <br /> a collusive or sham bid. <br /> Note: The above Non-collusion Affidavit is part of the Proposal. BIDDERS are <br /> cautioned that making false certification may s biect the certifier to <br /> criminal prosecution. <br /> Signed <br /> State of 46atiffe ff9 " <br /> County of S 6S IA <br /> Subscribed and sworn to (or affirmed) before me on this ' day of %� , 20-(, by <br /> proved to me on the basis of satisfactory evidence to be <br /> the person(s)who appeared before me <br /> Notary Public Signature Notary Public Seal <br /> MATTHEW KAPLAN, <br /> Notary Public <br /> Commonwealth of Nlassavnusetts <br /> My Comm.Expires May 21,2021 <br /> City Council 34 21 — 64 5/3/2022 <br />