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ATTACHMENT 3-1: NON -COLLUSION AFFIDAVIT <br />APPENDIX <br />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 />In accordance 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 person, <br />partnership, company, association, organization, or corporation; that the bid is genuine and not <br />collusive or sham; that the BIDDER has not directly or indirectly induced or solicited any other <br />BIDDER to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived <br />or agreed with any BIDDER or anyone else to put in a sham bid, or that anyone shall refrain from <br />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 <br />fix any overhead, profit, or cost element of the bid price, or of that of any other BIDDER, or to secure <br />any advantage against the public body awarding the contract of anyone interested in the proposed <br />contract; that all statements contained in the bid are We; and, further, that the BIDDER has not, <br />directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, <br />or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, <br />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 <br />signature porn of shall also constitute signature of this Non -collusion Affidavit <br />BIDDERS a calred that making a fa�e,ertifica ion may subject the certifier to criminal <br />prosecutlo . — <br />Signed <br />State of C is <br />County of <br />Subscribed atnd sworn to, car affirmed) before me on this L_7 day of,-��)V 20�by <br />AyJ�p(dG RcY (=xT>JEr+ rotors !roved to me an the basis of satisfactory evidence to be the person(s) <br />who appeared before <br />A}AMgA ROSE COW4U <br />10k, . D C tt12lM <br />MOTMY NEEICi LWMIW <br />M.EYM CMMTY <br />Co,m A}m OECFYBEE 14. MI} <br />Notary Public Signature Notary Public Seal <br />City of Santa Ana RFP 22-064 <br />Page 23 <br />Q Proposal for Grant Writing Services I Santa Ana Public Works Agency Page 30 <br />