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CITY OF SANTA ANA <br />RFP NO.: 22-023 <br />ARC FLASH ANAYLSIS AND ELECTRICAL, SAFETY PROGRAM DEVELOPMENT <br />NON -COLLUSION AFFIDAVIT <br />,Title 23 United States Code Section 112 and Public Contract Code Section 71061 <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. <br />any undisclosed person, partnership, company, association, organization, or <br />corporation; that the bid is genuine and not collusive or sham; that the BIDDER has not <br />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 <br />BIDDER or anyone else to put in a sham bid, or that anyone shall refrain from bidding; <br />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 <br />other BIDDER, or to fix any overhead, profit, or cost element of the bid price, or of that <br />of any other BIDDER, or to secure any advantage against the public body awarding the <br />contract of anyone interested in the proposed contract; that all statements contained in <br />the bid are true; and, further, that the BIDDER has not, directly or indirectly, submitted <br />his or her bid price or any breakdown thereof, or the contents thereof, or divulged <br />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 <br />agent thereof to effectuate a collusive or sham bid. <br />Note: The bove Non -collusion <br />c- tioned that making a <br />crimina pros ation. <br />Signed <br />Affidavit is pact of the Proposal. BIDDERS are <br />false certification may subject the certifier to <br />State of California <br />County of ---- <br />Subscribed anq sworn to (or affirmed) before me on this _ 02. day of �r , 20 ?2_ <br />bY_IiYC'�°t ia1gDksL_, proved to me on the basis of satisfactory evidence to <br />be the person( who appeared before me <br />Notary Public Sig o <br />_ tAvin I. Amtlwatn "� <br />�1- � CQMM. ri7.370A.03 z <br />� �'�<� l:. ��', Plotary puhlir, •California o z "y�r'i'• Ora,?ge County <br />��'�• iW Comr�n. Expires Au . 28 2025 <br />Notary Public Seal <br />A notary public or other officer completing this <br />a Iflcate verHles only the Identity of the indl. <br />vidual whOs nod tha documa d to which this <br />cedlflcate is attaChad, and not the truthfulness, <br />acouracy, or validity of that document. <br />Cdy of Santa Ana RFP 22-023 <br />Arc Flash Analysis and Electrical Safely Program Development <br />Page 38 <br />