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25D - AGMT - PREP CON PLAN
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25D - AGMT - PREP CON PLAN
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Last modified
7/31/2014 3:47:57 PM
Creation date
7/31/2014 1:48:21 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Community Development
Item #
25D
Date
8/5/2014
Destruction Year
2019
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EXHIBIT E <br />TO BE INCLUDED IN PROPOSAL <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 <br />Public Contract Code Section 7106) <br />To the CITY OF SANTA ANA COMMUNITY DEVELOPMENT AGENCY <br />In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the <br />PROPOSER declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, <br />partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or <br />sham; that the PROPOSER has not directly or indirectly induced or solicited any other PROPOSER to put <br />in a false or sham bid, and has not directly or indirectly colluded, conspired, connived or agreed with any <br />PROPOSER or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the <br />PROPOSER has not in any manner, directly or indirectly, sought by agreement, communication, or <br />conference with anyone to fix the bid price of the PROPOSER or any PROPOSER, or to fix any overhead, <br />profit, or cost element of the bid price, or of that of any other PROPOSER, or to secure any advantage <br />against the public body awarding the contract of anyone interested in the proposed contract; that all <br />statements contained in the bid are true; and, further, that the PROPOSER has not, directly or indirectly, <br />submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or <br />data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company <br />association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or <br />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 />nn1C lVanr•,.. <br />State of <br />County <br />of AC) t)/�Ue <br />Subscribed and sworn to (or affirmed) before me on day 20 by <br />this 0% _ of m�cx _l <br />proved to me on the basis of satisfactory evidence to be the <br />Ji'1Ci.f'c7n Iii SL- Ot"Y.2r person(s) COMMONWEALTH OF PENNSYLVANIA <br />who appeared before me. AH At. $EAL <br />E L EIPTnOTH <br />tary Public <br />,,,rrr^^^��� P., MONFIDE COUNTY � , �� Mn ExPiros May 2S, 201Z <br />Cr..Jfp r71 <br />Notary Pbblic Signature Notary Public Seal <br />City of Santa Ana Community Development Agency <br />Request for Proposals for Consolidated Five Year Plan Preparation <br />Page 25 <br />2501-23 <br />
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