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Appendix <br />ATTACIUVIE NT 3-1: NON -COLLUSION AFFIDAVIT <br />CERTIFICATIONS <br />NQN-COLLUSIONAFFIDAVITT <br />(Title 23 United States Code Section 112 and <br />Public Contract Code Section 7106) <br />To the CITY OF SANTA ANA DEPARTNIENT 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., above ollusion Affidavit is part of the Proposal, Signing this Proposal on the <br />s e <br />DA . rl� <br />igriature pot i ereo shall also constitute signature of this Non-oollusion Affidavit. BIDDERS <br />th <br />arecauntiom th*04ing a false certification may subject the certifier to criminal prosecution. <br />Signed <br />State of Califon 'a <br />County !��' —) <br />A and sworn to (or afflurned) before me on this 41 ' '39day of k(2T, 20�0 by <br />proved to me on the basis of satisfactory evidence to be the pmon(s) who appeared <br />before me. <br />7: <br />Notary Public Signature Notary Public Seal <br />City of Santa Ana RFP 23-134 <br />Page A3-1 <br />