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RE -ADVERTISEMENT <br />Appendix <br />ATTACHM i NT 3-1: NON -COLLUSION AFT IDAVIT <br />CERTIFICATIONS <br />NON -COLLUSION AFFIDAVIT <br />("title 23 United States Code Section 112 and <br />Public Contract Code Section 7106) <br />To the CITYOF SANTA ANA DEPARTMENT OF PUBLIC WORKS <br />In accordance with 'title 23 United States Code Section 112 and Public Contract Code 7106 the BIDDER <br />declares that the bid is not made in the interest of, or on behalf of any undisclosed person, partnership, <br />company, association, organization, or corporation; that the bird is genuine and not collusive or sham; that the <br />BIDDER has not directly or indirectly induced or solicited any other BIDDER to put in a false or sham bid, <br />and has not directly or indirectly colluded, conspired, connived or agreed with any BIDDETt or anyone else <br />to put hi a sham bid, or that anyone shall refrain from bidding; that the BIDDER has not in any manner, <br />directly or indirectly, sought by agreement, Communication, or conference with anyone to fix the bid price <br />of the BIDDER or any BIDDER, or to fix any overhead, profit, or cost element of the bid price, or of that of <br />any other BIDDER, or to secure any advantage against the public body awarding the contract of anyone <br />interested in the proposed contract; that all statements contained in the bid are true; and, further, that the <br />BIDDER has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the <br />contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any lee to any <br />corporation, partnership, company association, organization, bid depository, or to any member or agent <br />thereof to effectuate a collusive or sham bid. <br />Note; The above Non -collusion Affidavit is part 017 the Proposal. Signing this Proposal on the <br />signature portion thereof s all also constitutq signature of this Non -collusion Affidavit. BIDDERS <br />are cautioned that mgAiig lse cert&iicatiorAnkay subject the certifier to criminal prosecution. <br />Signed <br />State of California <br />County of Los Angeles <br />Subscribed and sworn to (or affirmed) before me on this I u day of p(L,I, , 20 P by <br />proved to me on the basis of satisfactory evidence to be the persons) who appeared <br />before me. <br />_"Ioy <br />Notary Public . 'gnature <br />ALICIA NGUYEN <br />,t Notary Public • Caafarnla <br />5 = Los Angeles County <br />Commission d 2375M6 <br />»o ^' My Comm. Expires Sep 23, 2025 <br />M <br />Notary Public Seal <br />City of Santa Ana RFP 21-095 <br />Page A3-1 <br />