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OFFICES <br />Cupertino <br />'.-Fresno <br />r <br />i- Irvine <br />'.fOakland <br />S Sacramento <br />Salinas <br />`cSon Jose <br />San Mateo <br />Walnut Creek <br />MARK THOMAS & COMPANY <br />Providing Engineering, Surveying & Planning Services <br />APPENDIX <br />ATTACHMENT 3-1: NON -CON -CO <br />LLUSION AFFIDAVI'P <br />CERTIFICATIONS <br />CITY OF SANTA ANA <br />REQUEST FOR PROPOSALS <br />FOR <br />ON -CALL ENGINEERING SERVICES — PART B <br />RFP NO.: 14-037B <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 Stntcs Code Section 112 and Public Contract Code 7106 the BIDDER declares that the bid <br />is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or <br />corporation; that the bid is genuine and not collusive or sham; that the BIDDER has not directly or indirectly induced or <br />solicited any other BIDDER to put in a false or sham bid, and has not directly or indirectly colluded, conspired, comived or <br />agreed with any BIDDER or anyone else to put in a shnnn bid, or that anyone shall refinin fi'onr bidding; that the BIDDER has <br />not in any manna, directly at indirectly, sought by agreement, communication, or conference with anyone to fix the bid price <br />of the BIDDER or any 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 advnnu ge against the public body awarding the contract of anyone interested in the proposed <br />contract; that all statements contained in the bid are true; and, farther, that the BIDDER fins not, directly or indirectly, <br />submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative <br />thereto, or paid, and will not pay, any tee to ally corporation, partnership, company association, organization, bid depository, <br />or to any member or agent thereof to effectuate a collusive or sham bid. <br />Note: Ti <br />e ab N ,,-collusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion <br />thereof0 aloe Lutesibm e f this Non -collusion Affidavit. BIDDERS arc cautioned that makingn false <br />certific tUbathccerti�e timivalprosecution. <br />Signed <br />State of California <br />County of r Ghlur��-n <br />Subscribed and sworn to (or affirmed) before me on thus Lkc -day of w , 20X.IC by In drIadt ✓w CherKey,, V\44-Arl NJAt <br />in to me on the basis of satisfactory evidence to be the person(s) who appeared before Inc. <br />I.AYN <br />Rm ssion 20195 <br />ARNEY <br />Commission tM 2019551 <br />Notary Public Signaturc Notary Public Seal �. Notary public - California <br />sacramantn County <br />MY Comm. Ex irae A r 24, 2017 <br />/ark Thomas & Company, Inc. <br />6795 Von Itarman Avenue, Suite 200, Irvine, CA 92606 <br />rvn rrorkthomas.com 19491477-9000 fax: 19491477-4109 <br />