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— — --- APPENDL% <br />ATTACHMENT 3-1: NON -COLLUSION AFFIDAVIT <br />CERTIFICATIONS <br />CITY OF SANTA ANA. <br />REQUEST FOR PROPOSALS <br />FOR <br />DAN YOUNG SOCCER COMPLEX FII+,LD #2 AND 94 SYNTHETIC TURF <br />RFP NO.: 16-01 <br />NON -COLLUSION AFFIDAVIT <br />(Title 23 United Suites Code Section 112 and <br />Public Contract Code Section 7106) <br />To tho 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 fixe bid <br />isnot made in the interest of, or on behalf of, any undisclosed Person, partnership, company, association, cgganuadon, 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 pat in a tease or sham bid, and has not directly or uxdirectly colluded, conspired, comilved or <br />agreed with, any BIDDER. or anyone else to put in a sham bid, or that aixyone shall refrain from bidding; that the BIDDER has <br />not in any manner, directly of 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 secrue any advantage against the public body awarding the contract of anyone interesiod in the proposed <br />contract; that all statements contained in the bid are true; and, further, that fixe 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 acollusive, or sham bid. <br />Note: The above Non -collusion Affidavil fs part of the Proposal. Signing this Proposal on the signature portion <br />thereof slial al o constitute sigua of tl Non -collusion Affidavit. BIDDERS are cautioned that making a false <br />certification ysbjectfhe�eeocTi prosecution. <br />Signed <br />nc1. <br />CaanKy OR <br />q <br />Subscribed and sworn to (or affirmed) before me on this day of c -(&24b by (� Az_ -_o <br />proved to me onthe basis of satisfactory evidence to be the person(s) who appeared before me. <br />Notary Public Signature Notary Public Seal <br />800hos chrislapor <br />Papaxiaa <br /># 212767 <br />City of Santa <br />cAnaa RFP 16-01 <br />2SaJ'L8 <br />