My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
20C - AA - AGMT - ENGINEERING SRVS
Clerk
>
Agenda Packets / Staff Reports
>
City Council (2004 - Present)
>
2016
>
05/03/2016
>
20C - AA - AGMT - ENGINEERING SRVS
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
5/23/2019 2:18:21 PM
Creation date
4/28/2016 2:23:04 PM
Metadata
Fields
Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
20C
Date
5/3/2016
Destruction Year
2021
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
56
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
EXHIBIT C I <br />APPENIi17s; <br />ATTACHMENT 3-I.: NON -COLLUSION AFFIDAVIT <br />_ ` T CERTIFI'CATIONTS _ <br />CITY OF SA.NTA ANA <br />REQUEST FOR PROPOSALS <br />FOR <br />STORM DRAIN MASTER FLAN PHASE 2 <br />RFP NO.: 16-02 <br />VON -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 that the bid <br />is not trade 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, connived or <br />agreed with any BIDDER or anyone else to put in a sham bid, or that anyone shall retrain from bidding; that the BIDDER bas <br />not in any manner, directly or 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 advantage 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, further, that the BIDDER has 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 fee to any corporation, partnership, company association, organization, bid depository, <br />or to any member or agent thereof to effectuate a collusive or strain bid. <br />Note: The above Non -collusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion <br />thereof shall also conitute ostsign or <br />this N n-collusion Affidavit. BIDDER'S are cautioned that making a false <br />certitiaalidnl}ray subject thc�eplr"(lcr to climinalprosecution, <br />Signed <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 person(s) who appeared before me. <br />v -e.ft- i, , , iB_ 1 <br />Notary Public Signature <br />Notary Public Seal <br />20C-51 <br />
The URL can be used to link to this page
Your browser does not support the video tag.