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EXHIBIT F <br />CITY OF SANTA ANA <br />REQUEST FOR PROPOSALS FOR <br />SECURE BIKE PARKING FACILITIES <br />Installation and Service Aareement <br />RFP #13-019 <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 sham <br />proposal, and has not directly or indirectly colluded, conspired, connived or agreed with any proposer or <br />anyone also to put in a sham proposal, or that anyone shall refrain from bidding; that the proposer has not in <br />any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the <br />proposal price of the proposer or any proposer, or to fix any overhead, profit, or cost element of the proposal <br />price, or of that of any other proposer, or to secure any advantage against the public body awarding the <br />contract of anyone interested in the proposed contract; that all statements contained in the proposal are true; <br />and, further, that the proposer has not, directly or indirectly, submitted his or her proposal price or any <br />breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not <br />pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any <br />member or agent thereof to effectuate a collusive or sham proposal. <br />Note: The above non Ilusion affid vit Is part of the proposal. Signing this proposal on the signature portion <br />thereof shal so c titute signaty�e of this noncolluston affidavit. Proposers are cautioned that making a <br />false certi ation m subject the er to criminal prosecution. <br />State of California, County <br />5 <br />Subscri¢ed and sworn to (or affirmed) before me on this day of 20 L3, by <br />-r'>e-ee _ M, r7lq1g:W gin , proved to me on the basis of satisfactory eviden a to be the personk who <br />appeared before me. <br />CDM2S DUANJ. E <br />1, E i373232 <br />iQ Of Cow Er. DM K 2012 <br />MMKY P uaauauu <br />OMM CM" <br />Notary public Sig r Y 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 NONRESPONSIVE. <br />City of Santa Ana RFP 13-019 <br />Page 25 <br />