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Appendix <br />ATTACHMENT 3 -1: NON - COLLUSION AFFIDAVIT <br />CGRTII+ICNHONS <br />CONSTRUCTABILITY REVIEW <br />NON - COLLUSION AVIT <br />AffU <br />(`Title 23 United States Code Section 112 and <br />Public Contract Code Section 7106) <br />To the CITY OF SANTA ANA DEPARTMEW OF PUBLIC WORKS <br />In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the BIDDER declares <br />that the bid is not made ¢t the interest of, or on behalf of, any undisclosed person, partnership, company, association, <br />organization, or corporation; that the bid is genuine and not collusive or share; that the BIDDER has not directly or <br />indirectly induced or solicited any other BIDDER to put in a false or sham bid, and has not directly or indirectly <br />colluded, conspired, connived or agreed with any BIDDER, or anyone else to put in a sham bid, or that anyone shall <br />refrain from bidding; 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 BIDDER, or to fix, any <br />overhead, profit, or cost element of the bid price, or of that of any other BIDDER, or to secure any advantage against <br />the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in <br />the bid are true; and, further, that the BIT) DER has trot, directly or indirectly, submitted his or her bid price or any <br />breakdown thereof! or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, <br />any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent <br />thereof to effectuate a collusive or sham bid. <br />Note. The abo e Non -c usron Affidavit is part of the Proposal, Signing this Proposal on the signature <br />portion the eof s mall al 6 a n }8 ittute signature of this Non - collusion. Affidavit. BIDDERS <br />are cautioned that <br />malting a f sc c ztifip ion !pay subject the certifier to criminal prosecution, <br />Signed <br />State of California <br />County of Q? <br />Subscribed and sworn to (or alUrmo(l) before me on this (^sl day of 1 4t i 20L7, by <br />proved to me on the basis of satisfactory evidenoe to be the person(s) who appeared <br />before me.. <br />City of Santa Ana RFP <br />Page A3 -1 <br />20A -22 <br />I-MMA SORTt) <br />0 <br />crsMM.rt2tnonya <br />"NO <br />> PPusLIC•CALIFOaNN 7l) <br />OP2AN ©�' OtlUN'1'Y CI <br />COMM.EXPIRES JAN.21, <br />p <br />Notary Public 9lgtlatUr'8li�u1'"9 <br />City of Santa Ana RFP <br />Page A3 -1 <br />20A -22 <br />