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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT N0. 14-6799: New Trefflc Signal on Newhore St and Camille St <br />PROJECT No, 14-6800: Traffic Signal Mod if [cation on Segeratrom Ave and Bear St <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 areca Toned that making a false certification may subject the certifier to criminal <br />prosecution <br />Signed ``- Elizabeth H. Mendoza de McRae, President/CFO <br />State of California <br />County of <br />Subscribed and sworn to (or affirmed) before me on this _ day of 20_, by <br />proved to me on the basis of satisfactory evidence to be the <br />person(s) who appeared before me <br />Notary Public Signature Notary Public Seal <br />BP -1.3 <br />