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CITY OF SANTA ANA <br /> PROPOSAL <br /> PROJECT NO.: 22-0504 <br /> COUNCIL CHAMBERS RESTROOM&TRANSLATION ROOM <br /> NON-COLLUSION 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 7106 the <br /> BIDDER declares that the bid is not made in the interest of, or on behalf of, any undisclosed <br /> person, partnership, company, association, organization, or corporation; that the bid is genuine <br /> and not collusive or sham; that the BIDDER has not directly or indirectly induced or solicited <br /> any other BIDDER to put in a false or sham bid, and has not directly or indirectly colluded, <br /> conspired, connived, or agreed with any BIDDER or anyone else to put in a sham bid, or that <br /> anyone shall refrain from bidding;that the BIDDER has not in any manner, directly or indirectly, <br /> sought by agreement, communication, or conference with anyone to fix the bid price of the <br /> BIDDER or any other 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 <br /> contract of anyone interested in the proposed contract;that all statements contained in the bid are <br /> true; and, further, that the BIDDER has not, directly or indirectly, submitted his or her bid price <br /> or any 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 association, <br /> organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham <br /> 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 criminal <br /> prosecution. <br /> Signed <br /> State of California <br /> County of <br /> Subscribed and sworn to (or affirmed) before me on this day of , 20_, by <br /> , proved to me on the basis of satisfactory evidence to be the <br /> person(s)who appeared before me <br /> &4e Anachoad, <br /> Notary Public Signature Notary Public Seal <br /> City Council P-11 of P 14 — 17 7/16/2024 <br />