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re1YHUm <br />City of Santa Ana Public Works Agency <br />On -Call Engineering Services • RFP No.: 14 -037 <br />APPENDIX <br />ATTACHMENT D -1: NON - COLLUSION AFFIDAVIT <br />CERTIFICATIONS <br />CITY OF SANTA ANA <br />REQUEST FOR PROPOSALS <br />FOR <br />ON -CALL ENGINEERING SERVICES <br />RFP NO.: 14.037 <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 hot 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 pot 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 falser certification �may fsubject the certifier to criminal prosecution. <br />SignedVt�`vcn<h`j" <br />State of California Matt Ulukaya <br />County of <br />Subscribed and sworn to (or affirmed) before me on this J day of am n+taF 20J_+ by <br />hqA±I_ij l uld,a.u( , proved to me on the basis of satisfactory evidence to be the person(s) who <br />appeared before me: <br />JULIE ANN NEAL <br />Commlulon N 2027242 <br />$ " Notary Public - California <br />2 ennen fmmN <br />City of Santa Ana RFP 14 -037 <br />Page 26 <br />25M -235 <br />