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EXHIBIT H
<br />CITY OF SANTA ANA
<br />REQUEST FOR PROPOSAL FOR
<br />CONSTRUCTION SURVEYING SERVICES
<br />NONCOLLUSION AFFIDAVIT
<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 parson, 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 else 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 noncollusion affidavit is part of the proposal. Signing this proposal on the signature portion
<br />thereof shall also constitute signature of this noncollusion affidavit. Proposers are cautioned that making a
<br />false certification may subject the certifier to criminal prosecution.
<br />State of Callfornla, County of OXMCIE
<br />pSu�,bscribed a9r�(�f,,s_worn,))o,,,,(or affirmed) before me on this 'V � day ofl�dy 0M, 20J3—, by
<br />1((r{C A iJ , proved to me on the basis of satisfactory evidence to be the persons) who
<br />appeared before me.
<br />Notary Public Signature
<br />GWEN DEI. CASTILLO
<br />fg
<br />U COMM.01460905
<br />0 OR
<br />NaE
<br />U
<br />No
<br />PORLIC-CALIPORNIA0
<br />NTY
<br />RANGE COUNTY 0
<br />COMM. EXPIRES YC IS_ OtS
<br />Notary Public Seal
<br />City of Santa Ana - Public Works Agency
<br />Construction Surveying Services RFP
<br />Page 30
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