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CITY OF SANTA ANA LOCAL STREET PAVEMENT REHABILITATION RESiDEN'I`IAL STREET REPAIR -PHASE l0 PROJECT NO. 10-6707-C PROPOSAL AND CONTRACT AGREEMF_NT NON-COLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7] 06) To the CI"I'Y 01= SANTA ANA DEPARTMENT OF PUBLIC WORKS In accordance with Title 23 United States Code Section 1 l2 and Public Contract Code 7106 the BIDDER 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 f?zlsc or sham bid, and has not directly or indirectly colluded, conspired, cortnivcd or agreed with any BEDDIR or smyonc else to put in a sham bid, or that anyone shall refrain from bidding; that the B[DDER has not in any manner. directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the BIDDER or any BIDDER, or to fix any overhead, profit, or cost element of the bid price, or of that 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 tnte; and, further, that the BIDDER. has not, directly or indirectly, submitted his or her hid price or any breakdown thereof, or the. contents thereof, or divulged infornlation or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association; organisation, bid depositary, or to any mcrnher or agent thereof to effectuate a collusive or sham bid. Note: The above Non-collusion AffidaviC is part of the Proposal. Signing this Proposal on the. signature portion thereof shall also constitute signature of this Non-collusion Affidavit. BIDDERS arc cautioned tha?t?making a false certification may subject the certifier to criminal prosecution. S i gnecl ?j?/?//A?/fin Steve ndoz Secretary State of California. County of Orange Subscribed and sworn to (or affirmed) before me on this 10tYr day of Nov_ 20 O? by Steve Mendoza _ proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. JENNIFER DE IONGH Commlaalon #r 1777186 < ; -s Notary Public - Colltornla ? ' ? Oranges County MY Comm. E>?Yes Oct 28, 201 1 ots r ' is ignaturo Notary Public Seal J nni a De =ongYr TO SE INCLUDF;D IN BID PAC:KACiF BP 12 of 14