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Appendix ATTA HIVIEN'''I' ;--(: NON..fOLLllSC.i7P411eE+'t<IDAVIT CLeRTIFICATIONTS CONSTRUCTABILITY REVIEW NON-CC)I.L.U5,1,0\ AFI=If_) BVI"I' (Title 23 United Slates Code Section 1 12 and pul)Iic Contract Code flection 71(16} to the CITY OF SANTA ANA DEPART1v9ENT OFPUBL IC WORKS ht accordance with Title 23 United States Code Section 112 and Public. Contract Code 7106 the BIDDER declares that the bid is not nhado in the it of, or on belabor, any unhdisolosod person, pill luershiIt, company, association, organization, or corporation; that Ile bid is gemrine and unt collusive or shall; that the BIDDER has not directly or indirectly Induced or solicited any other BIDDER to pul in it lidsc or sham bid, all([ has not directly or indirectly colluded, conspired, connived or agreed with any BIDDER or anyone else to put ill it sham bid, or that anyone shall rel ain from bidding;; that the BIDDER. has not in un)' ahanner, directly or indirectly, sought by agreement, conmaanicatiot, or conference with anyone to fix the bid price or the BIDDER nr any BIDDER, or to rix any overhead, profit, or cost element of the bid price, or o1'that of any other BIDDER, or In sceure any advantage against the public body awarding the contract of anyone interested in the proposed coonact; that all statements contained in the bid are lruu; and, further, that the BIDDER has not, directly or indirectly, submitted his or her bid price or any breakdown thereof or the contents thereof, or divulged Infornnatlon odata relative thereto, or paid, and will not pay, any fee to any corporation, Partnership, aTrnlmny association, of ginization, bid depository, ar to any member or agent thereof to o neotuate a collusive or sham bid. llote: The above Noncollusion AI"fidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall dsfj coljl�ute sigttahue of this Non -collusion t\fGdav{t BIDDERS are cautioned that makin `r I dva r;erhllcJRt, nal n prosecution. Sinned .,�1,y1 �l..z--1 r-1 i�•--f—*�It'_Gv�.._�'�.!____.... ._._� _.-- --- Stage of Califttir'nia County `subvrrihed and sworn to (or arflhmaed) hefore me on Ills _ ( _ day of .Ju.fy_ ?tl/Z-, by �._�_ t'als-_. _, proved to me on file basis of satisfactory evidence for be the, person who appeared befwe ma. 'atf4 r :.' p .2 ' Public Seal Nolyr}� P�b rc Signature Notary } �A2.AA.A.A/AAh4.2..AAnb.AA.AA.A1AC"Imyit MAh s oh It J. TOIIOIaYYK NOTAI4Y1'Unf IO-CAI.n°OrNIA CCUMISSION N 2007471 I;Sit"r,.J' ORANGE: COUNTY 7y.. My Comm, Exp. Jnnunry 17, 2019 -ov—✓wcww.r^vwvmuavvav�-raov+Yvv� city of Santa Ana gi=ro Pale A3-1 25G-22