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<br />Project S2:2011-2012 Omnibus Concrete Replacement Contract <br /> <br />CITY OF SANTA ANA <br />(Title 23 United States Code Section 112 and <br />TofheCITYOFSANTAANADEPARTMENTOFPUBLICWORKS <br />PROPOSAL AND CONTRACT AGREEMENT <br />NON-COLLUSION AFFIDAVIT <br />Public Contract Code Section 7106) <br />In accordance with Title 27 United States Code Section 112 and Public Contract Code 7106 (he BIDDER <br />the BIDDER has not directly or indirectly induct or solicited any other BIDDER to put in a false or sham <br />bid, and has not directly or indirectly colluded, conspired, connived or agreed with any BIDDER or one <br />elselo put In a sham bid, or Ihat anyone shall refrain from bidding; thaf fheBIDDER has not in any manner, <br />directly or Indirectly, sought by agreement, communication, or conference with anyone to ha the bid price <br />oftlse BIDDERorany BIDDER,or[o haany overhead, prof6orcostelement ofthe bid price,orofthat of <br />any other BIDDER, or to secure any advantage against (he public body awarding the contract of anyone <br />interested in the proposed contract; Eat all ?afemen(s cenlained in the bid are Ime; and, further, Ihat the <br />BIDDER has trop directly or indircetly, submitted his or her bid price or any breakdown fhercef, ar the <br />cements [hereof, or divulged information or Bala relative Iherelo, or paid, and will not pay, any 6lo any <br />cerporafion, partnership, cempany assoclation, organizellon, bid deposiNry, or ro any member or agent <br />Thereof to effceluatea collusive or sham bid. <br />declares flat the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, <br />company, association, organization, or corporation; that the hid is genuine and not collusive or sham; that <br />Note: The a6oue Non?collusion Affidavit is part of the Proposal. Signing This Proposal on the <br />signaturepoAionlhereofshallalsoconstitutesignalureof[hlsNon?cellusionAffidavit. BIDDERS <br />are ceutioned fhatmaking a false cedifivafion may subject IheceNEer to criminal prosecution <br />Signed e?y ? <br />SlateofCalifomla <br />County of <br />Subscribed and sworn (o (or affamed) before me on this ?? day of ?, 20?, by <br />proved ro me on the basis of 58tisfacfory eNdence to 6e the person(s) who <br />appeared before me. <br />? ?l,C?? S? A??? U?1?1 f1?N???6??11` <br />Notary PublicSlgnalure NolaryPublicS¢al <br />8P? 12 of 14