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CITY of SANTA ANA ATTACHMENT D NON Cot, WSION AFI 1DAVI I ( t,lle 13 t.)ntted 5131es {.Clip Serh:mn 1 is and Pubhf C ontrm -' r -.. - tt, the CI I � t>f SANiA ANA to accordance wath Title ; 3 United :Mates Code Section 112 and Puhlic-Ontract C=ode 'I Ek the cteC:ayes that the proposal is nol made In the interest of or on behalf of. any undisclosed perso^ Partnership company, association organization, or .orporation. that the proposal is genu'ne and nFl! cnllijsl�e or sham that the proposer his not directly or indirectly Induced Or sotcc+ted any 41her proOaSor tc pul in a false or shanr proposal, and has not directly or indirecly colluded conspired. ✓onr.ied Fil agreed write any proposer or anyone else to put in a Sham proposal, or that anyone shalt refrain fir,^-. bidding. that the proposer has not in arty manner directly or indirectly, sought Gy agree--ert comnwrucatton. or conference with anyone to fix the proposal price of the proposer or any propose- a' to fix any overhead, prollil. or cost element of the proposal priceor of that of any other propose'. or secure any advantage against the public body awarding the contract of anyone interested n '!.e Proposed contract. that all statements contained in the proposal are true and further. that the proposer has not. directly or Indirectly, submitted his or her proposal pnce or any breakdown thereof. Or Ine contents thereof, or divulged infoRnat+on or data relative thereto, or paid. and will not pay, any fee to any corporation, partnership, company association, organization, bid depository or to any member Or agent thereof to effectuate a collusive or sham proposal Note The above non-ctltusion of tdavrl :s part of the proposal. Sigrnn>y this proposal on the s;gnature Portion thereof shall also constitute signature of this non -collusion affidavit Proposers are cautioned !ha! making a false certification may sub;ed the certifier to cnminat prosecution State of _y (S , County of bscr t ed nd sworn to (or affirmedi before rite on this f .a 1 /; day of r iJJI t10 20 �� . by } r, C1 - j provea to me on the basis of satisfactory evidence to b the person(s) who appeared before me Notary Public Seal THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE_ _i?�nP Sa',td=fu FiFi'<4