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23B - PROJ - WARNER WATER AND SEWER IMPROV
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05/17/2016
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23B - PROJ - WARNER WATER AND SEWER IMPROV
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Last modified
5/12/2016 11:36:15 AM
Creation date
5/13/2016 8:51:14 AM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23B
Date
5/17/2016
Destruction Year
2021
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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO, 16 -6461 <br />WARNER INDUSTRIAL COMMUNITY WATER AND SEWER IMPROVEMENTS <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 are cautioned that making a false certification may subject the certifier to criminal <br />prosecution. 1 /7 <br />Signed <br />State of California <br />County of 0"MV76b- <br />Subscribed and sworn to (or affirmed) before me on this M1 day of f L 20A, by <br />j7d tJ \fit 1 f3C.K €3 proved to me on the basis of satisfactory evidence to be the <br />perso*j'who appeared before me NERNES SALVADOR TABADERO <br />COMM, #2066708 z <br />Notary Public • California a <br />= Orange County <br />��irM1 Comm. Ee ires May 30 2018 <br />Notry Public Signature Notary Public Seal <br />P -12 OF P -17 <br />23B -18 <br />
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