My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
25C - AGMT - CONSTRUCTABILITY REVIEW SRVS
Clerk
>
Agenda Packets / Staff Reports
>
City Council (2004 - Present)
>
2016
>
06/07/2016
>
25C - AGMT - CONSTRUCTABILITY REVIEW SRVS
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
6/2/2016 4:32:13 PM
Creation date
6/2/2016 2:45:24 PM
Metadata
Fields
Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
25C
Date
6/7/2016
Destruction Year
2021
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
70
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
Appe=ndix — --- — ._ <br />ATTACMal NT 3-1: NON - COLLUSION t1.1FI+AL AVIT <br />CONSTRUCTABILITY REVIEW <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 of any undisclosed person, partnership, company, association, orgattizaGon, 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 rafrain from bidding; that the BIDDER has <br />not in any Manuel', directly or Indirectly, sought by agreement, communication, a anyone to t x tiro bid price <br />conference with h <br />of the BIDDER or any BIDDER„ Otto fix any overhead, profit, or cost elarnent of the bid a, or of that of any other <br />BIDDER, or to secure any advantage against the public body awarding the contract of an <br />interestcd in the proposed <br />contract; that all statements contained in the bid are true; and, fiuther, that the $IDDER has not directly or indirectly <br />submitted his , her bid price y, any breakdown thereof, ,r the contents thereof, or divulged information or data relative <br />thereto, or paid, and will not pay, ally fee to any corporation, partnership, company association, organization, bid depository, <br />or to any member or agent thereof to effectuate a collusive or shah bid, <br />Note: The above Non - collusion 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 caudoned that making a false <br />certification may subject the certifier to criminal proscoution, <br />Signed /-i, J ~_ -t LU '� <br />State of C <br />County of <br />Subscribed and sworn to (or affurned) before me on filssiL- -day of ftW(�, 20j Ig by 2� <br />proved to me on the basis of satisfactory evidence to be the persons) who appeared before mo.— <br />, <br />�� „mesa ®mt <br />linly�u Iic ignature Tr„¢° ",� <br />Clty of Santa Ana Rrr i i -003 <br />Page A3 -1 <br />25C -19 <br />
The URL can be used to link to this page
Your browser does not support the video tag.