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.001: CITY OF SANTA ANA <br /> ATTACHMENT D <br /> NON-COLLUSION AFFIDAVIT <br /> (Title 23 United States Code Section 112 and Public Contract Code Section 7106) <br /> To the CITY OF SANTA ANA <br /> In accordance with Title 23 United States 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, organization, or corporation; that the proposal is genuine and not <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 /> agreed with any proposer or anyone else to put in a sham proposal, or that anyone shall refrain from <br /> bidding; that the proposer has not in any manner, directly or indirectly, sought by agreement, <br /> communication, or conference with anyone to fix the proposal price of the proposer 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, further, that the proposer <br /> has not, directly or indirectly, submitted his or her proposal price or any breakdown thereof, or the <br /> contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any <br /> corporation, partnership, company association, organization, bid depository, or to 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 this proposal on the signature <br /> portion thereof shall also constitute signature of this non-collusion affidavit. Proposers are cautioned that <br /> making a false certification may subject the certifier to criminal prosecution. <br /> Signed:J BradleyW <br /> State of CA- , County of �ICIG� <br /> Subscribed and sworn to (or affirmed) before me on this a a day of r, 1 , 20 ay , by <br /> (gradidi ta; Ikas , proved to me on the basis of satisfactory evidence to be the person(s) <br /> who appeafed before me. <br /> J r DONAL.D D. FISHER <br /> (}1 .c comm.#2436392 sn gay NOTARY PUBLIC C OFORNI <br /> Nota�r PuIb1lic Signature E'�'`s ' UNTY <br /> ,, ,, g 29,20271 <br /> SA v vIFO' <br /> THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. <br /> PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. <br /> City of Santa Ana RFP 24-051 Page 28 of 31 <br />