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CITY OF SANTA ANA <br />PROJECT NO. 16-6467 <br />SANTA ANA DELHI CHANNEL DIVERSION PROJECT <br />PROPOSAL <br />(ADDENDUM ONE - JULY 22, 2016) <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 112 and Public Contract Code <br />7106 the BIDDER declares that the bid is not made in the interest of, or on behalf of, <br />any undisclosed person, partnership, company, association, organization, or <br />corporation; that the bid is genuine and not collusive or sham; that the BIDDER has not <br />directly or indirectly induced or solicited any other BIDDER to put in a false or sham bid, <br />and has not directly or indirectly colluded, conspired, connived or agreed with any <br />BIDDER or anyone else to put in a sham bid, or that anyone shall refrain from bidding; <br />that the BIDDER has not in any manner, directly or indirectly, sought by agreement, <br />communication, or conference with anyone to fix the bid price of the BIDDER or any <br />BIDDER, or to fix any overhead, profit, or cost element of the bid price, or of that of any <br />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 <br />the bid are true; and, further, that the BIDDER has not, directly or indirectly, submitted <br />his or her bid price or any breakdown thereof, or the contents thereof, or divulged <br />information or data relative thereto, or paid, and will not pay, any fee to any corporation, <br />partnership, company association, organization, bid depository, or to any member or <br />agent thereof to effectuate a collusive or sham bid. <br />Note: The above Non -collusion Affidavit is part of the Proposal. Signing this <br />Proposal on the signature portion thereof shall also constitute signature of this <br />Non -collusion Affidavit. BIDDERS are cautioned that making a false certification <br />may WbjectAhp certifier to criminal prosecution. <br />Signed 0 <br />State of California <br />County of o, A ii6c— <br />Subscribed and sworn to (or affirmed) before me on this day of , 20_, <br />by , proved to me on the basis of satisfactory evidence to <br />be the person(s) who appeared before me <br />Notary Public Signature Notary Public Seal <br />City of Santa Ana / Project 16-6467 Santa Anf5D6j0Y I Diversion Project / REBID - October 7, 2016 <br />