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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 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 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 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, subrrdtted 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 Affidavit is part of the Proposal. Signing this Proposal on the <br />si ature rtion thereof s 1 als onstitute signature of union Affidavit. BIDDERS <br />are cacti nil that r�ikiytg lse to su ject the certifier to criminal prosecution. <br />Signed <br />State of CvA46i:64 LR#-fltr <br />County of 5 is rt M rr <br />Subscribed and sworn to (or affirmed) before me on this I day of J'­U 1 , ZOvk�, by <br />!;arct H proved to me on the basis of satisfactory evidence to be the person(s) who appeared <br />before me. <br />ary sgnature Notary Public Seal <br />GREG FLINT <br />AVOTARYPUBLIGSTATE OF UTAH <br />ffl�) <br />COMMISSION EXP. 0311612025 <br />COMMISSION NO. 717363 <br />City of Santa Ana RFP <br />Page A3-1 <br />