Laserfiche WebLink
Docusign Envelope ID: EFBAE12B-2D33-4288-BDF3-3F19BEEB5A9F <br />ATTACHMENT D <br />NON-COLLUSION AFFIDAVIT <br />(Title 23 LJnited States Code Section 112 and Public Contract Code Section 7al06) <br />To the CITY OF SANTA ANA <br />In accordance with Title 23 Llnited States Code Section 1 '12 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 proposed <br />contract; that all statements contained in the proposal are true; and, further, that the proposer has not, <br />directly or indirectly, submitted his or her proposal price or any breakdown thereof, or the contents thereof, <br />or divulged 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 to <br />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 certifier to criminal prosecution <br />Signed <br />State of j;j;, County of Oran:)e <br />S"ubslr'bLand?leWorn'o\,-i,(Oraff'prmroevds!btoefm0reeomnethOen'bhassiso2""'tnsdatist'adcatoyryofevsioeepn1ceemtobebrethe2pOe27-5son(sbr <br />who appeared before m <br />N'otaqlbllcslgn< ItuLJre l <br />;('/ OrangeCoun!y -5 <br />Notary Public Seal <br />THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. <br />rr?or'os/kl Q THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. <br />RFP 25-109A City of Santa Aria Page 47 of 50