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Appendix <br />ATTACHMENT 34: NON -COLLUSION AFFIDAVIT <br />CERTIFICATIONS <br />NON 4,OLLUSION Al"DAVTC <br />(Title 23 United States Code Section 112 and <br />Public Contr%,t 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 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 bid is genuine and not collusive or sham; that <br />the BIDDER has not directly or indirectly induced or solicited any other BIDDER to put in a false or sham <br />bid, and lids not directly or indirectly coltuded, conspired, connived or agrood with any BIDDER or anyone <br />else to put in a sham bid, or that anyone shall refrain from bidding; that the BIDDER has not in any <br />manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the <br />bid price of the BIDDER or any 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 contract <br />of anyone interested in the proposed contract; that all statements contained in the bid are true; mid, further, <br />that the BIDDER has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or <br />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 <br />thereof to effectuate a collusive or sham bid. <br />Note: The above Non -collusion <br />signature portion t�1 all also <br />are cautio d Ytiat nT<�kin false ec <br />c <br />Signed <br />State of California <br />County of 1.•cs_ s fEn�je(eS <br />4 <br />z' of the Proposal. Signing this Proposal on the <br />acre of this Non -collusion Affidavit. BIDDERS <br />subject the certifier to eriniintd prosecution. <br />Subscribed and sworn to (or affirmed) before me, on this —7-- day of hkv ,• 2021 by <br />(,tvvs �1Yayr,gri , proved to Inc on the basis of satisfactory evidence to be the pCrson(g)• who appeared <br />before me. <br />Notary lyablie Signature <br />ASTRID MORAN 0 <br />0 1 COMM.2321p11 <br />C = •! NUTANY PU4UC•CALIFORNtA N <br />LdA MOELEa COUNTY -� <br />I My Cantu. EMpltes Fab <br />.17, 2024 6 <br />City of Santa Ana RFP 21-190 <br />Page A3-1 <br />Seal <br />