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APPENDIX <br />ATTACHMENT 3-1. C'FCaN-CCil LU ION AF+�'F+IDAVTT <br />ITT OF SANTA. ANA <br />REQUEST FOR 'T1d, POSAt;;si <br />FOR <br />f AVEM NT MANAGEMENT PROGRAM UPN?Arc <br />RFP NO., 15-102 <br />(Title 23 United Stntcs (aide Section 112 and <br />Public C0110act Coda Section 710(i) <br />To die CITY OF SANTA ASIA DIARTMPN'T' pF PUBLIC WORKS <br />In accordance with Tittc 23 United States Code Section 112 and Public Couirmt Code 7106 die BIDDER declares that the bid <br />is taut made in the interest of or on bcbatf of,, any undisclosed person, partnership, companyassociation, organization, of <br />corporation; that the bid is-gxnrnine and not collinsive or sbam that des: BIDDER has not directly or iodix€:cdy induced or <br />solicited any other BIDDER to pat hi it f dse or share bid, and has not directly or hubmiiy colluded, conspired, connived or <br />agwcd with any BIDDER or anyone else to put in a shrift bid, or that anyone shall refrain frons bidding; that the EILkDE R has <br />not is any anatager, directly or indirectly, sought by agreentent couunauaicati to or coufen;nce Avith anyone to its tare bid price <br />of the BIDDER or any BIDDER, or to fix, any ovprbead, profit, or Lost elert)cnt of flee bid price, or or That of ally other <br />BIDDER, or to sedurt~ my advantage against the public body asraritibig the onutrnck of anyrim intemstod in tho propmed <br />epttttact� that all statements mota1ned in the bill are true; anis; lurtlaer„ that the BIDDER has roL directly or indirectly, <br />submitted his or her bid price or a" breakdown thereof, or the contents dwreof, or divulged infoxsnation or data relative <br />thercetx), or paid, .and will not pay, any fee to any Corporation, piartnersh p, company association; organization, bid depository, <br />Of tit MY Member or agent tlremof to ofteduaic a collusive or shaxix bid.,. <br />Note: Tin, above Non -collusion Affidavit is pat# of doe lrroprasat. Signing; this Proposal ort lire Signature portion <br />thereof sl'xall also cons€ione tignaturc ofdris'Non—collusion Affidavit. BIDDERS are cautioned that racking a table <br />c«rlxtictrdon nuly subject the certifier to'crittataal prosecution, <br />signed — <br />SkaGcoPCal>£nruita - <br />couitty of--'4iJ v <br />Subscribed and mvorn to (or niffiruxed) before sna szai this _ dayr of .�!vv , 20-0- f,, by <br />prOved to Mon the basis sni'tu du%ctory tt ldencc to be thepamins3 who appealed befoee etre. <br />ra' <br />Notary Public Signature <br />lig CUiu.A 2100579 <br />NOTARY Puaan•eam <br />n <br />< <br />�.,.. <br />my anal U.- <br />Notary Public Sea] <br />City of Santa Ana REV' 15-102 <br />Page 22 <br />