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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 <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 <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 <br /> signature portion thereof shall also constitute signature of this non-collusion affidavit. Proposers <br /> are cautioned that making a false certification may subject the certifier to criminal prosecution. <br /> Signed <br /> State of . County of <br /> Subscribed and sworn to (or affirmed) before me on this day of <br /> 20 , by , proved to me on the basis of satisfactory evidence to <br /> be the person(s) who appeared before me, <br /> SEE ATTACHED <br /> NOTARIAL CERTIFICATE <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 <br /> NONRESPONSIVE. <br /> City of Santa Ana RFP No.25-019A Page 68 of 101 <br />