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20B - AA - STREETCAR DESIGN
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20B - AA - STREETCAR DESIGN
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Last modified
12/1/2016 3:58:36 PM
Creation date
12/1/2016 3:51:14 PM
Metadata
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
20B
Date
12/6/2016
Destruction Year
2021
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CITY OF SANTA ANA <br />RFP NO.; 16-125 <br />OC STREETCAR DESIGN REVIEW SUPPORT <br />NON -COLLUSION AFFIDAVIT <br />(Title 23 United States Code Section 112 and Public Contract Code Section 7106) <br />hi conformance with Title 23 United States Cade 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 bit], 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 />BIDDER or any other BIDDER, or to fix any overhead, profit, or cost element of the bid price, <br />or of 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 thereof to effectuate a collusive or sham <br />bid. <br />Note: The above Nan -collusion Affidavit is pant of the Proposal. BIDDERS are <br />cautioned that making a false certification may subject the certifier to criminal <br />prosecution. <br />Signed <br />State of California <br />County of Ofn"2' <br />Subscribed and sworn to (or affirmed) before me on this *,A day of Pd!6e , 20)b, by <br />5crihe âś“hrnald 0(Ahde,ItA. proved to me on the basis of satisfactory evidence to be the <br />person(s) who appeared before me <br />Notary Public Signature <br />EMMA S®RTO r1 <br />t) .p <br />Vit. <br />COMM.82M0476 <br />NOTARY MMIC-CALWORMAfIi <br />ORANGE COUNTY (h <br />20B-31 <br />aosw <br />Page I of I <br />
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