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CITY OF SANTA ANA <br />RFP NO.: 21-033 <br />ON -CALL HVAC MAINTENANCE AND REPAIR SERVICES <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 />7106 the BIDDER declares that the bid is not made in the interest of, or on behalf of, any <br />undisclosed person, partnership, company, association, organization, or corporation; that <br />the bid is genuine and not collusive or sham; that the BIDDER has not directly or indirectly <br />induced or solicited any other BIDDER to put in a false or sham bid, and has not directly <br />or indirectly colluded, conspired, connived, or agreed with any BIDDER or anyone else to <br />put in a sham bid, or that anyone shall refrain from bidding; that the BIDDER has not in <br />any manner, directly or indirectly, sought by agreement, communication, or conference <br />with anyone to fix the bid price of the BIDDER or any other BIDDER, or to fix any <br />overhead, profit, or cost element of the bid price, or of that of any other BIDDER, or to <br />secure any advantage against the public body awarding the contract of anyone interested <br />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 <br />breakdown thereof, or the contents thereof, or divulged information or data relative <br />thereto, or paid, and will not pay, any fee to any corporation, partnership, company <br />association, organization, bid depository, or to any member or agent thereof to effectuate <br />a collusive or sham bid. <br />Note: The above Non -collusion Affidavit is part of the Proposal. BIDDERS are <br />cautioned that making apse certification may subject the certifier to <br />crirr,>ipal prp<e_�ution. Z / <br />� `O���f%/����/ Helen Leonard <br />/ I <br />Signed Annir.i....4 C�....�..L.. <br />State of California <br />County of / 5e,& gELo,) <br />Subscribed and sworn to (or affirmed) before me on this day of 20_, by <br />proved -to me on the basis of satisfactory evidence to be <br />the persons) who appeared before me <br />Notary Public Sign9ture Notary Public Seal <br />An olary public or other officer completing this certifcate verifies orSy the idenfty cf thni <br />i„dividual who signed the document to which this certificate is attached, and not thel <br />truthfulness, accuracy, orvalidity of that document. <br />STATE OF CALIFORNIA COUNTY OF Los W(, F-LCS <br />Subscribed and sworn to(or affirmed) before meonthis Q"tayof PPRf1. <br />20,9-1_ by HVL 44 Le-a4KI> <br />proved to me on the basis of satisfactory eviden be n(s) who appeared <br />before me. <br />(Signature of hJnt <br />TONYTIGRANKARA•SIMONYAN <br />a " ' Notary Public - California <br />Los Angeles County <br />Commission # 7264183 <br />My Comm. Expires Nav 20, 2022 <br />Page 1 of 1 <br />