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Appendix <br />ATTACHMENT 3-1: NON -COLLUSION AFFIDAVIT <br />CERTIFICATIONS <br />CONSTRUCTABILITY REVIEW <br />NON -COLLUSION AFFIDAVIT <br />(Title 23 United States Code Section 112 and <br />Public Contract Cade Section 7106) <br />To the CITY OF SANTA ANA DEPARTMENT OF PUBLIC WORKS <br />In accordance 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 of, or on behalf of, any undisclosed person, partnership, <br />company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the <br />BIDDER has not 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 BIDDER or anyone else to <br />put in a sham bid, or that anyone shall refrain from bidding; that the BIDDER has not in any manner, directly <br />or indirectly, 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 that of any <br />other BIDDER, or to secure any advantage against the public body awarding the contract of anyone <br />interested in the proposed contract, that all statements contained in the bid are true; and, further, that the <br />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 member or agent <br />thereof to effectuate a collusive or sham bid. <br />Note: The above Non -collusion Affidavit is part of the Proposal. Signing this Proposal on the <br />signature portion thereof shall also constitute signature of this Non -collusion Affidavit. BIDDERS <br />are captioned that mak a false certification may subject the certifier to criminal prosecution, <br />Signed J�'4-- <br />State of California <br />County of <br />Subscribed and sworn to (or affirmed) before me on this _ day of , 20� by <br />proved to me on the basis of satisfactory evidence to be the person(s) who <br />appeared before me. <br />yr_= <br />Gem <br />1A 1Ac�ar10 <br />Notary Public Signature <br />Notary Public Seal <br />City of Santa Ana RFP 17-057 <br />Al2(47 <br />