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23A - PROJ - TRAFFIC SIGNAGE
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04/04/2017
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23A - PROJ - TRAFFIC SIGNAGE
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Last modified
3/30/2017 6:03:03 PM
Creation date
3/30/2017 5:32:07 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
4/4/2017
Destruction Year
2022
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CITY OF SANTA ANN <br />PROPOSAL <br />PROJECT NO.: 15 -6833 <br />TRAFFIC SIGNAGE UPGRADE <br />FEDERAL PROJECT NO: IISIPL 5063(157) <br />NON - COLLUSION AFFIDAVIT <br />(Title 23 United States Code Section 112 and Public Contract Code Section 7106) <br />In conformance with Title 23 'United States Code Section 112 and Public Contract Code 7106 the BIDDER <br />declares that the bid is not made in the interest o£, or on behalf of, any undisclosed person, partnership, <br />company, association, organization, or corporation; that die bid is genuine and not collusive or sham; that <br />the BIDDER has not directly or indirectly induced or solicited any other BIDDER to put in a false or sham <br />bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any BIDDER or anyone <br />else to put In a sham bid, or that anyone shall refrain from bidding; that the BIDDER has not in any manner, <br />directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price <br />of the BIDDER or any other 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 contract of <br />anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that <br />the BIDDER has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the <br />contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any <br />corporation, partnership, company association, organization, bid depository, or to any mernber or agent <br />thereof to effectuate a collusive or sham bill. <br />Note: The above Non - collusion Affidavit is pant of the Proposal, BIDDERS are cautioned that <br />making a false eeitificatiou may subject tire, certifier to criminal prosecution, <br />Signed <br />State of California <br />County of SEE Attached Acknowledgement <br />Mike Rodgers, President <br />Subscribed and sworn to (or aftirtnod) before me on this ..._ clay of , 20, by <br />proved to me on the basis of satisfactory evidence to be the person(s) who <br />appeared before nre <br />Notary Public Signature .Notary .Public Seal <br />P -I1 of P-38 <br />23A -22 <br />
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