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9() <br />CITY OF SANTA ANA <br />REQUEST FOR PROPOSALS <br />FOR <br />DESIGN AND CONSTRUCTION SUPPORT OF THE SANTA ANA DELHI DIVERSION PROJECT <br />RFP NO. 14 -069 <br />APPENDIX <br />ATTACHMENT D -1: NON- COLLUSION AFFIDAVIT <br />CERTIFICATIONS <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 7106 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 shall 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, or to 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 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 the signature <br />portion thereof shall also constitute signature of this Non - collusion Affidavit. BIDDERS are cautioned that <br />making a false certification may subject the certifier to criminal prosecution. <br />Signed - <br />r- <br />Richard Hart, Vice President, URS Corporation Americas <br />State of California <br />County of <br />S }}��bsQribed MA sworn to (or affirmed) before me on this �� ` day of )) 20� by <br />((j (� f y( j y (f �( proved to me on the ba ' KEL Y P. O'CONNOR the person(s) who <br />appeared before me. COMM. #2085476 z <br />X Notary Public - California <br />Z QMV Orange County <br />t C omm. EX ireS Oct. 10, 2018 <br />Nota Pub(lia/S{igna� mature Notary Public Seal <br />THIS FORM MUST BE COMPLETED AND INCLUDE'. <br />PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE <br />20299 <br />