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25I - AGMT - TRAFFIC MANAGEMENT SYS
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08/20/2012
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25I - AGMT - TRAFFIC MANAGEMENT SYS
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Last modified
8/16/2012 5:02:47 PM
Creation date
8/16/2012 5:02:42 PM
Metadata
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
25I
Date
8/20/2012
Destruction Year
2017
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EXHIBIT F <br />NON-COLLUSION AFFIDAVIT <br />CITY OF SANTA ANA <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 <br />In accordance with Title 23 United States Code Section 112 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, partnership, <br />company, association, organization, or corporation; that the proposal is genuine and not collusive or sham; that <br />the PROPOSER has not directly or indirectly induced or solicited any other PROPOSER to put in a false or <br />sham proposal, and has not directly or indirectly colluded, conspired, connived or agreed with any PROPOSER <br />or anyone else to put in a sham proposal, or that anyone shall refrain from bidding; that the PROPOSER has <br />not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix <br />the proposal price of the PROPOSER or any PROPOSER, or to fix any overhead, profit, or cost element of the <br />proposal price, or of that of any other PROPOSER, or to secure any advantage against the public body <br />awarding the contract of anyone interested in the proposed contract; that all statements contained in the <br />proposal are true; and, further, that the PROPOSER has not, directly or indirectly, submitted his or her <br />proposal price or any breakdown thereof, or the contents thereof, or divulged information or data relative <br />thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, <br />bid depository, or to any member or agent thereof to 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 thereo hall also constitut signature of this Non-collusion Affidavit. PROPOSERS are <br />cautioned thff U&kin1A4aIW cert' ation may subject the certifier to criminal prosecution. <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 />C'er-t-i?i a-?e o-E f? naw I Pd9 ??nQ?T <br />PI eat S Attadld <br />Notary Public Signature Notary Public Seal <br />THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL <br />PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NON-RESPONSIVE <br />251-27
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