|
CITY OF SANTA ANA
<br />RFP NO.: 23-014
<br />CONSUMER CONFIDENCE REPORT (CCR) AND AUXILIARY SERVICES
<br />NON-COLLUSIQN 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 BDDER 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 a false certification may subject the certifier to
<br />Signed
<br />State of Califpar!a
<br />Countyof,
<br />Sscribed a-�nr-dsworn to (or affirmed) before me on this j i day of IE 2�' y
<br />,y,r,�,, proved to me on the basis of satisfactory evidence to be
<br />the person(sj who appeared befo^reyN
<br />re \ Notary Public Seal
<br />µ,aalwtl: one np m� •'-.. - knAn vs _L<W�nnriAi.rCirrtnN
<br />511 is5
<br />ubaCMpl[O'gh'Q"\nrdnU sa
<br />wcor_dnUtndt,y(daVve�f�ya;_g/yr_'3^i1eCdyt e
<br />�
<br />•' t4*10,710
<br />qnKa`cwry_$tlenQd b
<br />.d"." 1l
<br />/ i f
<br />YA
<br />�, t }
<br />,
<br />City of Santa Ana RFP 23-
<br />Consumer Confidence Report (CCR) and
<br />Page 32
<br />
|