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[elk W9141 SI _ V i 1 _L 1 P 1_ 1 <br />PROPOSAL <br />NON - COLLUSION AFFIDAVIT <br />(Title 23 United States Code Section 112 and <br />Public Contract Code Section 7106) <br />In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the <br />BIDDER declares that the bid is not made in the interest of, or on behalf of, any undisclosed <br />person, partnership, company, association, organization, or corporation; that the bid is genuine <br />and not collusive or sham; that the BIDDER has not directly or indirectly induced or solicited any <br />other BIDDER to put in a false or sham bid, and has not directly or indirectly colluded, conspired, <br />connived or agreed with any BIDDER or anyone else to put in a sham bid, or that anyone shall <br />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 <br />BIDDER, or to fix any overhead, profit, or cost element of the bid price, or of that of any other <br />BIDDER, or to secure any advantage against the public body awarding the contract of anyone <br />interested in the proposed contract; that all statements contained in the bid are true; and, further, <br />that the BIDDER has not, directly or indirectly, submitted his or her bid price or any breakdown <br />thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will <br />not pay, any fee to any corporation, partnership, company association, organization, bid <br />depository, or to any member or agent thereof to effectuate a collusive or sham bid. <br />Note: The above Non - collusion Affidavit is part of the Proposal. Signing this Proposal on <br />the signature portion thereof shall also constitute signature of this Non - collusion Affidavit. <br />BIDDERS are cautioned that ma a false certification may subject the certifier to criminal <br />prosecution. <br />Signed <br />State of California f <br />County of <br />Subscribed a61 sworn to (or affirmed) before me on this � — day of 204 by <br />c'ru� �ti proved to me on the basis of satisfactory evidence to be the <br />p�rson(s) who appeared before me <br />r <br />G "r` <br />Notary ublic S goture Notary Public Seal <br />m a ® ,CYNTHIA J. VALENCIA <br />Commission la 1952790 <br />Notary Puhlic - California q <br />� e Orange County <br />My Comm. Expires Oct 15, 2095 N <br />P -7 <br />Section 3 -b Proposal 09 -22 -201 n <br />23A -42 <br />