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EXHIBIT C <br />Appendix <br />A.TFACFUMENT3-1;NO.."-COLLUSIONAFFIDAVIT <br />CERTIFICATIONS <br />NO-COLLUSIONA'FFIDAV[T <br />(Title 23 Unitcd States Code Section 112 and <br />Public Contract Code Secllon 7106) <br />To the CITY or SANTA ANA DEPARTMENT OF PUBLIC WORKS <br />In accordance with Tide 23 United States Code Section 112 and Public Contract Code 7106 the BIDDER declares <br />that the bid is nor made in the interest of, or on behalf of, nny undisclosed person, partnership, company, association, <br />organization, or corporation; that the bid is genuine and not collusive or shah; 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 BIDMR or anyone else to put to 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 bill are true; and, further, that the BIDDER has not, directly or indirectly, submitted his or her bid price or any <br />breakdown thereof, or the contents thereof; or divulged information or data relative thoratn, or paid, and will not pay, <br />any fee to any corporation, parmership, 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 pact of the Proposal. Signing this Proposal on the signature <br />portion thereot'shall also constitute signature ot'this ;'Jon -collusion AFfdavh. BIDDERS aur, cautioned that <br />making a false certification may sabicct the, certifier to criminal prosecution, <br />Signed <br />State of California <br />County of-0-1^006k� <br />Subscribed and sworn to (or affirmed) before me on this )O' day of i�y_, 20t-1, by <br />tow O � Part , proved to the on the basis of satisfactory evidence to be the persons) who appeared <br />before me. <br />BaYppptpONO MEflARMDHFR YpaepprlaBpp� <br />APU ON00N <br />NOTARY PU6Utl• Cow%t02I291 ng <br />✓' l l '.YS �rs ORANGE�,✓ COUNTExOAI.IFOitNIA w hly Car;mission pires i9,'Sn9 a <br />tlpC9pay pp BY<i BP epBaap9pY Ypq pappaa BeYYA <br />Afvy�Publ tgnature Notary Public Seal <br />City of Santa Ana RFP <br />Page A3.1 <br />25A-21 <br />