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City of Santa Ana, PWA <br />RFP — Fats, Oils, and Grease (FOG) Control Management Program <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 <br />proposer declares that the proposal is not made in the interest of, or on behalf of, any <br />undisclosed person, partnership, company, association, organization, or corporation; that the <br />proposal is genuine and not collusive or sham; that the proposer has not directly or indirectly <br />induced or solicited any other proposer to put in a false or sham proposal, and has not directly <br />or indirectly colluded, conspired, connived or agreed with any proposer or anyone else to put in <br />a sham proposal, 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 <br />to fix the proposal price of the proposer or any proposer, or to fix any overhead, profit, or cost <br />element of the proposal 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; <br />that all statements contained in the proposal are true; and, further, that the proposer has not, <br />directly or indirectly, submitted his or her proposal price or any breakdown thereof, or the <br />contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any <br />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 no collusion affidavit is part of the proposal. Signing this proposal on the <br />signature portion thereof shall also constitute signature of this no collusion affidavit. Proposers <br />are cautioned that making a false certification may subject the certifier to criminal prosecution. <br />Sig <br />State of California, County of Ora <br />Subscribed and sworn to (or affirmed) before me on this day of <br />20 , by , proved to me on the basis of satisfactory evidence to <br />be the person(s) who appeared before me. <br />Notary Public Signature Notary Public Seal <br />THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. <br />PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED <br />NONRESPONSIVE. <br />a] <br />25E -48 <br />