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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 c ifter to_ 'mina pr ecution. <br /> Signed <br /> State of(G It{ail( County of ca e3 0 <br /> Subscribed and sworn to (or ffirmed) before me on this I 9 day of A/VA/CV' , 20 Z(, by <br /> -V&w tj3 CO'1, proved to me on the basis of satisfactory evidence to be the person(s) <br /> who appeared before m <br /> ,�_ •. EDITHEUZ0ND0 <br /> Notary Public•California <br /> i 57. San Diego County <br /> • /-: Commission 8 2477598 <br /> ` '� My Comm.Expires Jan 7,2028 <br /> gj'76kite- <br /> Notary Public Signature Notary Public Seal <br /> THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. <br /> PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. <br /> RFP 24-022A City of Santa Ana Page 45 of 51 <br /> Page 28 of 33 <br />