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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 AN.A 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 directIv 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 any <br />manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the <br />bid price of die BIDDER or any BIDDER, or to fx 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 lies, 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 Affidavit is part of the Proposal. Si6ming this Proposal on the <br />signature portion thereof shall also constitute signature of this Non -collusion Affidavit BIDDERS <br />are cautioped that m*-Ing a false certification may subject the certifier to criminal prosecution. <br />Signed <br />State of California <br />County of O (Gs,► <br />Subscribed and sworn to (or affirmed) before me on tliis 2 day of 20 Z( b} <br />Cott i LeiNker , proved to me on the basis of satisfactory evidence to be the persons) who appeared <br />before me. <br />Notary Public Signature Notary Public Seal <br />.. of j...PARKE ....... R AL CHANATI: <br />COMM # 2352652 z <br />x Los Angeles County `n <br />California Notary pubii <br />�P CCmm ... IF-0? .......... Ex P M 5 <br />as,. 23, 242 <br />City of Santa Ana RFP <br />Page A3-1 <br />