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CITY OF SANTA ANA COMMUNITY DEVELOPMENT <br />REQUEST FOR PROPOSALS FOR MODERNIZATION TO DOWNTOWN PARKING METERS <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 Public Contract Code Section 7106) <br />To the City of SANTA ANA COMMUNITY DEVELOPMENT AGENCY <br />In accordance with Title 23 United State Code Section 112 and Public Contract Code 7106 the PROPOSER <br />declares that this 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 />PROPOSER has not directly or indirectly induced or solicited any other PROPOSER to put in a false or sham <br />bid, and has not directly or indirectly colluded, conspired, connived or agreed with any PROPOSER or anyone <br />else to put in a sham bid, or that anyone shall refrain from bidding; that the PROPOSER has not in any <br />manner, directly or indirectly, sought by agreement, communication or conference with anyone to fix the bid <br />price of the PROPOSER or any PROPOSER, or to fix any overhead, profit, or cost element of the bid price, or <br />of that of any other PROPOSER, or to secure any advantage against the public body awarding the contract of <br />anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that <br />.e contents thereof, or divulged information or data relative thereof, or paid, and will not pay, any fee to any <br />corporation, partnership, company associations, organization, bid depository, or to any member or agent <br />thereof to effectuate a collusive 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. PROPOSERS are <br />cautioned that making a false certification 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 rl, 20 l , by <br />r A- K (� i i_c'` (� / l , proved to me on the basis of satisfactory evidence to the person(s) <br />who appeared before me. <br />Notary Public Signature Notary Public Seal <br />N. S. YBM11M <br />�,o­�, ss or No. 203M <br />N ASN', PJNIIC CAUFO0 <br />1 SAN D�EGOCOW" ' <br />My Comm Eaplrea AUOWf71, 70/1 <br />.�r <br />