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- endix <br />rp <br />AT'fACHMENT 3-1: NON -COLLUSION AMDAVIT <br />CERTMCATIONS <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 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 has not directly or indirectly colladed, conspired, conttived 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 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; and, 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 />I <br />Note: The above Non -collusion Affidavit is part of the Proposal Signing this Proposal on the <br />signature portion thereof shall also constitute signature of this Non -collusion Affidavit. BIDDERS <br />are cautioned that making a false certification may subject the certifier to criminal prosecution. <br />Signed <br />C"s <br />State of California <br />County of _ <br />Subscribed and sworn to (or affirmed) before me on this _ day of _, 20--, by <br />before me. . proved to me on the basis of satisfactory evidence to be the person(s) who appeared <br />Notary Public Signature Notary Public Seal <br />,,,TARy PU13LIC <br />SEE ATTACHED <br />City of Santa Ana RFP 22-097 <br />Page A3-1 <br />ill I 0361-11:1=11 IN11 M, I 11*41 to] IV kyj I Vl 0 Lei I ill 1:1:1 10 101 Leim4:191 IN 01 W-11 &111 aft-11 10M Lel ill Xu M <br />JP0 <br />449 <br />A A. I rit'X, r17'J7L <br />