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APPENDIX <br />ATTACHMENT 5: CERTIFICATIONS <br />NON -COLLUSION AFFIDAVIT <br />(Title 23 United States Code Section 112 and Public Contract Code Section 7106) <br />In conformance with Title 23 United States Code Section 112 and Public Contract Code <br />710E the BIDDER declares that the bid is not made in the interest of, or on behalf of, <br />any undisclosed person, partnership, company, association, organization, or <br />corporation; that the bid is genuine and not collusive or sham; that the BIDDER has not <br />directly or indirectly induced or solicited any other BIDDER to put in a false or sham bid, <br />and has not directly or indirectly colluded, conspired, connived, or agreed with any <br />BIDDER or anyone else to put in a sham bid, or that anyone shall refrain from bidding; <br />that the BIDDER has not in any manner, directly or indirectly, sought by agreement, <br />communication, or conference with anyone to fix the bid price of the BIDDER or any <br />other BIDDER, or to fix any overhead, profit, or cost element of the bid price, or of that <br />of any other BIDDER, or to secure any advantage against the public body awarding the <br />contract of anyone interested in the proposed contract; that all statements contained in <br />the bid are true; and, further, that the BIDDER has not, directly or indirectly, submitted <br />his or her bid price or any breakdown thereof, or the contents thereof, or divulged <br />information or data relative thereto, or paid, and will not pay, any fee to any corporation, <br />partnership, company association, organization, bid depository, or to any member or <br />agent thereof to effectuate a collusive or sham bid. <br />Note: The above Non -collusion Affidavit is part of the Proposal. BIDDERS are <br />cautioned that making a false certification may subject the certifier to <br />Signed <br />State of California <br />County of Ventura <br />Subscribed and sworn to (or affirmed) before me on this _6th day of October , 21 21, <br />by Micbaet J LeBlanc , proved to me on the basis of satisfactory evidence to <br />be the person(s) who appeared before me <br />Nota P blic Signature Notary Public Seal <br />C. JONES <br />COMM. *2288015 z <br />Notary Public - California o <br />z Ventura County -� <br />my C <br />m. resft fQ 2t123 <br />City of Santa Ana - RFP 21-100 <br />Water Resources Panel Building Services <br />Page 35 of 39 <br />8of11 <br />