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CITY OF SANTA ANNA <br />PROPOSAL. <br />PROJECT NO.: 1.5-2647 <br />MEMORY LANE - SANTA ANA RIVER PARI <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 7,106 the <br />BIDDER declares that the bid is not made .ln 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 shall refrain 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 />B'I'DDER 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 bid 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 thcreof 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 sha11 also constitute signature of this Non -collusion <br />Affidavit, BIDDERS are cautioned that malting a false, certification may subject the <br />certifier to crirn ptrl pyq ecution., <br />Signed <br />State of California <br />Countyof ORANGE„_ <br />Subscribed and sworn to (or affirmed) before me on this _ clay of Feb . _, 20 1 j by <br />_ proved to me on the basis of satisfactory evidence to be the <br />person(s) who appeared before me <br />,' <br />s r1 i'a9'i'I; HI'AI;iSSM 1'OR <br />N troy Public Signature � � Notary Public Seal `111 [1#ll NA.. WWI A'010F)IN <br />P-12 ofP-17 <br />