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23A - PROJ - SAFE TRANSIT STOPS
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23A - PROJ - SAFE TRANSIT STOPS
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Last modified
6/2/2016 4:29:48 PM
Creation date
6/2/2016 3:46:42 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
6/7/2016
Destruction Year
2021
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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 15 -6843 <br />SAFE TRANSIT STOPS <br />NON - COLLUSION AFFIDAVIT <br />(Title 23 United States Code Section 1.12 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 <br />any other BIDDER, to put in a false or sham bid, and has not directly or indirectly colluded, <br />conspired, connived or agreed with any BIDDER or anyone else to put in a sham bid, or that <br />anyone sball refiain from bidding; that the BIDDER, has not in any manner, directly or indirectly, <br />sought by agreement, communication, or conference with anyone to fix the bid. price of the <br />BIDDER or any BIDDER, or to fix any overhead, profit, or cost element of the bid price, or of <br />that of any other BIDDER, or to secure any advantage against the public body awarding the <br />contract of anyone interested in the proposed contract; that all statements contained in the bid are <br />true; and, further, that the BIDDER has not, directly or indirectly, submitted his or her bird price <br />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, <br />organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham <br />bid. <br />Note: The above Non - collusion Affidavit is part of the Proposal. Signing this Proposal . <br />on the signature portion thereof shall also constitute signature of this Non- collusion <br />Affidavit. BIDDERS are cautioned that Ina mg ?alse Celt if, atir�l may subject the <br />certifier to criminal prosecution. X �/ �� <br />Signed <br />State of California <br />County Of ORANGE <br />Subscribed and sworri to (or affirmed) before <br />Michael Martin , proved to me on <br />persons) who appeared b .fare me <br />Notary Public Signature <br />rote on this 26th day of April , 201q by <br />the basis of satisfactory evidence to be the <br />NICK MAPTiN <br />Commission S 1978781 <br />Notary Public - California a <br />Z a. ' Orange County <br />I My Gomm. Expires May 27,_2.018 c <br />Notary Public Seal <br />W1J <br />
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