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APPENDIX <br />ATTACHMENT 3-I: NON-COLLU,114ON AFFIDAVIT <br />C .RTIFICA.TIONS <br />CITY OF SANTA ANA <br />REQUEST .I+Olt PROPOSALS <br />FOR <br />FOUNTAIN MAINTENANCE <br />R FP NO.: 21„102 <br />NON-CQLL;(.IS:IQN E11a ID.AV!'J <br />(Title 23 United States Code Section 112 and <br />Public Contract Code Section 7106) <br />To the CITY CAP SANTA ANA PARKS, RECREATION AND COMMUNITY SERVICES AGENCY <br />In accordance with Title 23 United States Code ,Section l l2 and. Public Contract Code 7106 the BIDDER declares that the bid <br />is not made in the interest of, or on behalf of, any undisclosed Berson, partnership, company, association, organization, or <br />corporation; that the bid is genuine and not collusive or sham; that the 13IDDLR has not directly or indirectly induced err solicited <br />any other BIDDER to put in a false: or share bid, and has not directly or indirectly colluded, conspired, connived or agreed with <br />any 13IUDER or anyone else to pert in a sharer bid, or that anyone shall refrain from bidding; that theBIDDER has not in any <br />manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the <br />BIDDER or any BIDDER, or to fix any 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 in tho proposed contract; that all <br />statements contained in the bid are true; and, further, that the BIDDER has not, directly or indirectly, submitted his or her bid <br />price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not <br />pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any rnernber or agent <br />thereof to effectuate a collusive o►*adbid. <br />Note: The above Non-c Sion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof <br />shall also constitute si lure of this Non -collusion Affidavit, BIDDERS are cautioned that making a false certification <br />Wray subject the eery to criminal prose crttion. <br />Signed <br />This fovea must be signed above. This form mustalso be notarized for Public Works contrac# . <br />State of California <br />County of rj �" <br />* - a r A'rt 9) <br />Subscribed andsworn to (or affirmed) before me on this day of , 20—, by , proved <br />to me on the basis of satisfactory evidence to be the person(s) who appeared before nee. <br />Notary Public Signature .Notary Public Seal <br />8! <br />....Gity-ofSartte-Ana RFR 21 102 <br />Wage 29 <br />