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APPENDIX <br />EXHIBIT D-1: NON -COLLUSION AFFIDAVIT <br />CERTIFICATIONS <br />CITY OF <br />REQUEST .,PROPOSALS <br />.- <br />• • r <br />s r <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 7146 the BIDDER declares <br />that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, <br />association, organization, or corporation; that the bid is genuine and not collusive or sham; that the BIDDER has <br />not directly or indirectly induced or solicited any other BIDDER to put in a false or sham bid, and has not directly or <br />indirectly colluded, conspired, connived or agreed with any BIDDER or anyone else to put in a sham bid, or that <br />anyone shelf refrain from bidding that the BIDDER has not in any manner, directly or indirectly, sought by <br />agreement, communication, or conference with anyone to fix the bid price of the BIDDER or any BIDDER, orto fix <br />any overhead, profit, or cost element of the bid price, or of that of any other BIDDER, or to secure any advantage <br />against the public body awarding the contract of anyone interested in the proposed contract; that all statements <br />contained in the bid are true; and, further, that the BIDDER has not, directly or indirectly, submitted his or her bid <br />price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid; <br />and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to <br />any member or accent thereof to effectuate a collusive or sham bid. <br />Note; The abi <br />portion thereof <br />making a false <br />Signed <br />State of California <br />County of Orange <br />Subscribed and swom tc <br />Subhas_Khara <br />appeared before me, <br />Notary Public Signature <br />allusion Affidavit is part of the Proposal. Signing this Proposal on the signature <br />constitute signature of this Non -collusion Affidavit. BIDDERS are cautioned that <br />n may subject the certifier to criminal prosecution. <br />(or affirmed) before me on this 27th day of May , 2Q_14, by <br />f <br />proved to me on the basis of satisatory evidence to be the person(s) who <br />Notary Public Seal <br />City of Santa Ana MP 14026 <br />Page 24 <br />CPmmtssl ...... wmaA; <br />Netarypubtia. iaifiszr <br />Californiay(o <br />orange Cn <br />Cnmm <br />