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SECTION 2 1 Certifications <br />Appendix <br />ATTACHMENT3-1: NON-COLLUSIONAFFIDAVIT <br />CERTIFICATIONS <br />NUN-C OLLCSI ON AFFI DA\1 T <br />( Title 23 Gaited Stales Code Section 112 and <br />Public Contract Code Section 7106) <br />I o the CITYOF SAN IA 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 Ls not made in the interest of or on behalf of, ana 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 indirecth induced or solicited any other BIDDER to put in a false or sham <br />bid. and has nut directly or indirectly colluded. conspired, connived or agreed 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 am' <br />manner, directly or indirectly. sought by agrcennent, 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 it the proposed contract: that all statements contained in the bid are true: and, huther. <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. amp fee to <br />any corporation, partnership, company association- organization, bid depositor', or to any member or agent <br />thereof to e ffectuate a collusive or sham bid. <br />Note: The above Non -collusion Affidavit is pan of doe Proposal. Signing this Proposal on the <br />sigmaare portion thereof shall also constitute signature of this Non -collusion Affidavit. BIDDERS <br />are cautioned that making a false <br />certification may subject the certitierto criminal prosecution. <br />Signed�/�!��-��lil.i <br />State of California <br />County of oAe4/'I <br />t,�cgl cd�an s s% n t rop for affirmed) before me on this day ol'IN�A„ 2U2_31+, <br />fIn. 0:l roved to me on the hasis of satisfacto evidence to be the persons %% ho appeared <br />before me. <br />j 1 plwcou <br />I r+aury Publk.[elllnnla <br />3's Olenge County <br />ComY bp, 2 <br />-" wY Comm.. Expkrplre,,, Sep I0026 <br />Yma-4 A kz- <br />11W Public . ' matt re Notary Public Seal <br />City of Santa Ana RFP 22-097 <br />Page A3-1 <br />22 in r r m <br />