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Certifications <br />Appendix <br />ATTACHMENT 3-I: NON -COLLUSION AFFIDAVIT <br />CERTIFICATIONS <br />NON -COLLUSION AFFIDAVIT <br />(Title 23 United States Code Section 112 and <br />Public Contract Code Section 7106) <br />To the CITY OF SANTA ANA DEPARTMENT 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 the <br />BIDDER has not directly or indirectly induced or solicited any other BIDDER to put in a false or sham bid, <br />and has not directly or indirectly colluded conspired, connived or agreed with any BIDDER or anyone else <br />to put in a sham bid, or that anyone shall refrain From bidding; that the BIDDER has not in any manner, <br />directly or indimcdy, sought by agreement, communication, or conference with anyone to fix the bid price <br />of the BIDDER or any BIDDER, or to fix any overhead, profit, or cost element of the bid price, or of that of <br />any other BIDDER, or to secure any advantage against the public body awarding the contract of anyone <br />interested in the proposed contract; that all statements contained in the bid are true; and, Ibrther, that the <br />BIDDER has not, directly or indirectly, submitted his or her bid 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 bid. <br />Note: The above Non -collusion Affidavit is pan of the Proposal. Signing this Proposal on the <br />signature portion thereof shall also constitute signature of this Non -collusion Affidavit. BIDDERS <br />are cautioned that making a fi)kse certification may subject the certifier to criminal prosecution. <br />Signed <br />State of Cal iif��o"rrn���•i,,,�a <br />Coun���j(,,��,, DDDQ <br />ty of <br />Subscribed and sswom to (or affirmed) before me on this `in day of �Pn`I . 200 by <br />�-tV•{ Zl�/if proved to me on the basis of satisfactory evidence to be the persons) who appeared <br />hefar t e <br />'v <br />Notdry Public Si ure <br />f ANGIr C <br />Noury r "CmAry -CRI <br />MI S = ega Ceunry <br />y� ' m. Expir f 707p1 <br />mr - <br />A ay Ceram. &parer Nw i'. 7C: <br />Notary Public Seal <br />City of Santa Ana RFP #24-035 <br />Page A3-1 <br />Proposal jor On -Call Plan Checking Services 21 <br />