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CITY OF SANTA ANA CITYWIDE RESIDENTIAL STREET REPAIR - PHASE 14 PROJECT NO 10-6730 PROPOSAL AND CONTRACT AGREEMENT NON-COLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY OF SANTA ANA DEPARTMENT OF PUBLIC. WORKS In accordance with Title 23 United States Code Section 1 12 and Public Contract Code 7106 the BID ?)F,R declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham: that the BIDDER has not directly or indirectly induced or solicited any other BIDDER to put in a false or! ham bid, and has not directly or indirectly colluded, conspired, connived or agreed with any BIDDER or an one else to put in a sham bid, or that anyone shall refrain from bidding; that the BIDDER has not in any ma lncr, directly or indirectly; sought by agreement, communication, or conference with anyone to fix the bid )rice of the BIDDER or any BIDDER, or to fix any overhead, profit, or cost element of the bid price, or of treat of any other BIDDER, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are tnze; and, further, that the BIDDER has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, oi- the contents thereof" or divulged information or data relative thereto, or paid, and will not pay, any fee to, any corporation, partnership, company association, organization. bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Non-collusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Non--collusion Affidavit. BIDDERS are cautioned that r iking a false certification may subject the certifier to criminal prosecution. Signed X State of California County of ORANGE MICHAEL J. CARVER, PRESIDENT Subscribed and sworn to (or affirmed) before me rnn this 28 clay of JULY 2010, by MICHAEL J. CARVER proved to Inc on the basis of satisfactory evidence to be the person(s) who appeared before me. 1 a Aai?y Pr`tl ]c Signature ? f Jennif r De Iongh N ?ENIEER DE IONGH Commission # 1771186 -oso Notary Public - California Z Orange County ¦7 t+!ry '_ Of m. Expires Oct 28, 2011 Notary Public Seal TO 13F. INCLUDED IN 1311) PACKAG I3P 12 of 15