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CITY OF SANTA ANA <br />PROJECT 06 -3000: BOWER'S MUSEUM OVERFLOW PARKING LOT <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 <br />the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, <br />and has not directly or indirectly colluded, conspired, connived or agreed with any bidder or anyone else to <br />put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly <br />or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the <br />bidder or any bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of any other <br />bidder, 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, <br />partnership, company association, organization, bid depository, or to any member or agent thereof to <br />effectuate a collusive or sham bid. <br />Note: The above Non - collusion Affidavit is part of the Proposal. Signing this Proposal on the <br />signature ortion thereof shall also constitute signature of this Non - collusion Affidavit. Bidders are <br />ca at makir g a alse rt fication may subject the certifier to criminal prosecution. <br />Signed <br />Subscribed and sworn to before me this <br />Notary Seal: <br />JO —A,NN LYON <br />COMM. 115701461 <br />�! <br />WARY PUKIC- (,ALIFORNIAr4 <br />OFtANfC COUNTY <br />MY COMM. EMP. APR, 17, 2009 y <br />BP 11 of 13 <br />