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CITY OF SANTA ANA <br />PROJECT N0.08-5018: TRAFFIC SIGNAL INSTALLATION ON HAZARD AVE & ROSITA ST <br />PROJECT N0.08-5019: TRAFFIC SIGNAL INSTALLATION ON HAZARD AVE E/O GATES ST <br />PROJECT NO. 08-5020: TRAFFIC SIGNAL MODIFICATION ON MCFADDEN AV & NEWHOPE AV <br />PROPOSAL AND CONTRACT AGREEMENT <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 declares <br />that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, <br />association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has <br />not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly <br />or indirectly colluded, 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, sought by <br />agreement, communication, or conference with anyone to fix the bid price of the bidder or any bidder, or to fix <br />any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any advantage <br />against the public body awarding the contract of anyone interested in the proposed contract; that all statements <br />contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid <br />price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, <br />and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or <br />• to any member or agent thereof to effectuate a collusive or sham bid. <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 his Non-collusion Affidavit. Bidders are cautioned that <br />making a false certific may 'ec ertifier to criminal prosecution. <br />Signed <br />and <br />Signed <br />Notary Seal: k c <br />• <br />J. Erno, President <br />re me this <br />,20 <br />Notary Public <br />~~Clntd uv~t ~~ <br />TO BE INCLUDED IN BID PACKAGE <br />BP 13 of 32 <br />