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CITY OF SANTA ANA <br />..... ... ram.. <br />.................. <br />ti _ <br />,,,....5�� ors:+. .. .. ....: �� _ _ ��D_ ... <br />(Title 23 Unified States Code Section 112 and Public Contract Code Section 7106) <br />To the CITY OF SANTA ANA <br />In accordance with Title 23 United Mates Code Section 112 and Public Contract Code 7106 the proposer <br />declares that the proposal is not made in the interest of, or on behalf of, any undisclosed person, <br />partnership, company, association, organisation, or oDWration; that the proposal is genuine and nol <br />collusive or sham; that the proposer has not directly or indirectly induced or solicited any other proposer <br />to put in a false or sham proposal, and has not directly or indirectly colluded, conspired, connived or <br />sgneed vuith any proposer or anyone else to put in a sham proposal, or that anyone shall refrain torn <br />bidding, that the proposer has rat in any rrranner, directly or indirectly, sought by agreement, <br />communication, or conference with anyone to fix the proposal price of the imposer or any proposer, or <br />to fix any overhead, profit, or cost element of the proposal price, or of that of any other proposer, or to <br />secure any advantage against the public body awarding the contract of anyone interested in the <br />proposed contract: that all statements contained in the proposal are true; and, farther, that the proposer <br />has not, directly or indirectly, submitted his or her proposal price or any t7reakdown thrfreof, or the <br />contents thereof, or divulged information or data r$Iatnre thereto, or paid, and will not pay, any fee to any <br />corpora -ion. partnership, company association, organization, bid depositary, ort❑ any member or agent <br />thereof to effectuate a collusive or sham proposal. <br />Note, The above non -collusion affidavit is part of the proposal_ Signing tins proposal on the signature <br />portion thereof shall also constitute signature of this non -collusion affidavit. Proposers are cautioned that <br />making a false cefflication may subject the certifierto criminal prosecution_ <br />Sig <br />State of CA County of Dranp <br />Subscribed and sworn to (or affirmvd) hefare me on this 29th day of Februartir , 20 24 , by <br />Kassle Radermacher , proved to me on the basis of satisfactory evidence to he the person(s) <br />who appeared befora Me. <br />N-;�WJ----- -- IMY 5. 302� <br />Notary Public Signature Notary Public Seal <br />THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. <br />PROPOSALS THAT DO NOT CONT► IN THIS FORM WILL BE CONSIDERM NONRESPONSIVE. <br />City of Santa Ana RFP No. 24-009 Page 53 of 63 <br />