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Item 28 - On -Call Right -of -Way Specialty Services
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05/17/2022 Special and Regular
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Item 28 - On -Call Right -of -Way Specialty Services
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City Clerk
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Agenda Packet
Agency
Clerk of the Council
Item #
28
Date
5/17/2022
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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, 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 />Note: The a e Non -collusion Affidavit is part of the Proposal. Signing this Proposal on the <br />signattirepgqliov thereof shall also constitute signature of this Non -collusion Affidavit. BIDDERS <br />are cauti at makirWcertification may subject the certifier to criminal prosecution. <br />Signed <br />State of California <br />County of I as 4nsz,._le-5 <br />Subscribed and swom to (or affin-ned) before me on this _La day of 90 c 20?�. , by <br />Oylyra LV"4 j2e5ol&a.31proved to me on the basis of satisfactory evidence to be the person(s) who appeared <br />before m . <br />SZOZ TZ 130 saltdq wura� AW <br />uo <br />ZOLUIZ r issl WIX _ <br />AwnoD saiaBuV sal _ I <br />eiuuople7 - xiq% Fjmw <br />PJV16131YS OVONH3W <br />Notary PLIWC Signature Notary Public Seal <br />City of Santa Aria RFP 21-131 <br />Page A3-1 <br />
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