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25G - AGMT - BROKERAGE SRVS
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05/17/2016
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25G - AGMT - BROKERAGE SRVS
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Last modified
5/13/2016 5:01:25 PM
Creation date
5/13/2016 4:49:17 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
25G
Date
5/17/2016
Destruction Year
2021
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ATTACHMENT 3 -1: NON- COLLUSION AFFIDAVIT <br />CITY OF SANTA ANA. <br />REQUEST FOR PROPOSALS <br />FOR <br />ON CALL RESIDENTIAL & COMMERCIAL BROKERAGE SERVICES <br />RFP NO.; 15 -103 <br />NON - 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 made in the interest of, or on behalf or, 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 refrain from bidding; that the BIDDER has <br />not in any manner, directly or indirectly, sought by agreement, communication, or confcrence 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 sham bid. <br />Note,. The above Non- collusivb Affidavit is part of the Proposal. Signing this Proposal on the signature portion <br />thereof shall also constitute signature of this Non-collusion Affidavit. BIDDERS are cautioned that making a false <br />certification may sLb*t thplicnifier to criminal prosecution, <br />Signed <br />State of California <br />Subscribed and sw (or affirmed) before me on this day of <br />proved ro me on the basis o ' factory evidence to be the person(s) who a <br />Notary Public Signature „,,- Notary Public, Seal <br />City of Santa Aft RFP 15 -103 <br />Page 24 <br />25G -35 <br />
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