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+CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 16 -2671. <br />BOMO KORAL SIDEWALK RENOVATION <br />NON - COLLUSION AFFIDAVIT <br />(Title 23 United States Code Section 112 and <br />Public Contract Code Section 7106) <br />In accordance with Title 23 United States Code Section 1.12 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 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 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 a] I 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 Non - collusion Affidavit is part of the Proposal. Signing this Proposal <br />on the signature po,'>n thereof shall also constitute signature of this Non - collusion <br />Affidavi, . <br />certifier to <br />Signed <br />Slate � California <br />County 8f*., <br />Subscribed and s) <br />BIDDE are pputoed that making a false certification may subject the <br />affirmed) before me on this day of <br />�royed to me on the basis of satisfactory <br />person(s) who appeared before me <br />Notary Public Signature <br />Notary Public <br />23AL22 <br />__, 20__, by <br />evidence to be the <br />