Laserfiche WebLink
EXHIBIT H <br />CITY OF SANTA ANA PUBLIC WORKS AGENCY <br />REQUEST FOR PROPOSALS FOR STREET SWEEPING <br />NON-COLLUSION AFFIDAVIT <br />CITY OF SANTA ANA <br />PROPOSAL AND CONTRACT AGREEMENT <br />NON-COLLUSION AFFIDAVIT <br />(Title 23 United States Code Section 112 and <br />Public Contract Code Section 7106) <br />To the CITY OF SANTA ANA DEPARTMENT OF PUBLIC WORKS <br />In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the BIDDER <br />declares that 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 bid is genuine and not collusive or sham; that the <br />BIDDER has not directly or indirectly induced or solicited any other BIDDER to put in a false or sham bid, and <br />has not directly or indirectly colluded, conspired, connived or agreed with any BIDDER or anyone else to put in <br />a sham bid, or that anyone shall refrain from bidding; that the BIDDER has not in any manner, directly or <br />indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the BIDDER <br />or any BIDDER, or to fix any overhead, profit, or cost element of the bid price, or of that of any other BIDDER, <br />or to secure any advantage against the public body awarding the contract of anyone interested in the <br />proposed contract; that all statements contained in the bid are true; and, further, that the BIDDER has not, <br />directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or <br />divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, <br />company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive <br />or sham bid. <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. BIDDERS are cautioned <br />that making a false certification may subject the certifier to criminal prosecution. <br />Signed <br />State of California <br />County of <br />Subscribed and sworn to (or affirmed) before me on this day of , 20 , by <br />, proved to me on the basis of satisfactory evidence to be the person(s) who <br />appeared before me. <br />Notary Public Signature <br />Notary Public Seal <br />TO BE INCLUDED IN PROPOSAL PACKAGE <br />25H-63