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CITY OF SANT A 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
<br />proposer declares that the proposal is not made in the interest of, or on behalf of, any undisclosed
<br />person, partnership, company, association, organization, or corporation; that the proposal is
<br />genuine and not collusive or sham; that the proposer has not directly or indirectly induced or
<br />solicited any other proposer to put in a false or sham proposal, and has not directly or indirectly
<br />colluded, conspired, connived or agreed with any proposer or anyone else to put in a sham
<br />proposal, or that anyone shall refrain from bidding; that the proposer has not in any manner,
<br />directly or indirectly, sought by agreement, communication, or conference with anyone to fix the
<br />proposal price of the proposer or any proposer, or to fix any overhead, profit, or cost element of
<br />the proposal price, or of that of any other proposer, or to secure any advantage against the public
<br />body awarding the contract of anyone interested in the proposed contract; that all statements
<br />contained in the proposal are true; and, further, that the proposer has not, directly or indirectly,
<br />submitted his or her proposal price or any breakdown thereof, or the contents thereof, or divulged
<br />information or data relative thereto, or paid, and will not pay, any fee to any corporation,
<br />partnership, company association, organization, bid depository, or to any member or agent thereof
<br />to effectuate a collusive or sham proposal.
<br />Note: The above non-collusion affidavit is part of the proposal. Signing this proposal on the
<br />signature portion thereof shall also constitute signature of this non-collusion affidavit. Proposers
<br />are cautioned that m • alse certification may subject the certifier to criminal prosecution.
<br />Armqptbli: or-otrmr00111'"'1ilg tllil C8lti1ic,lo vertiol ort, 1111
<br />._,..,dthe individual wto 1i,inod lhe documonl towllicl1 INII criicalt 11
<br />ll'd not 1h11 IMhflkess, acn,racy, or validiy ol Iha docunenl.
<br />Subscribed and s~orn to ( or affirmed) before me on this :z q day of Jl1ud '
<br />20~ by f 1A.t, t'ne, ,'1,cr/t... ~\~proved to me on the basis of satisfactory evidence to
<br />be the person(s) who appeared before me .
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<br />O SEAN s. HASHEMI O {
<br />COMM. # 2363432 ;a
<br />NOTARY PUBllC•CALIFORNIA ~
<br />ORANGE COUNTY N
<br />-OCO!™}~· J~N~ 30,:,20~ l
<br />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
<br />NONRESPONSIVE.
<br />EXHIBIT 3
<br />
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<br />City Council 10 – 348 7/1/2025
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