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25D - AGMT - PD JANITOR
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25D - AGMT - PD JANITOR
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Last modified
8/31/2017 4:04:56 PM
Creation date
8/31/2017 3:58:58 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Police
Item #
25D
Date
9/5/2017
Destruction Year
2022
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EXHIBIT K <br />CITY OF BANTA ANA <br />REQUEST FOR PROPOSALS FOR JANITORIAL SERVICES <br />NON -COLLUSION AFFIDAVIT <br />NON -COLLUSION AFFIDAVIT <br />(Title 23 United States Code Section 1 t2 and <br />Public Contract Code Section 7106) <br />To the CiTY OF SANTA ANA: <br />In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the proposer <br />declares that the proposal Is not made In the Interest of, or on behalf of, any undisclosed person, <br />partnership, company, association, organization, or corporation; that the proposal Is genuine and not <br />collusive or sham; that the proposer has not directly or indirectly Induced or solicited any other proposer <br />to put to a false or sham proposal, and has not directly or indirectly colluded, conspired, connived or <br />agreed with .any proposer or anyone else to put in a sham proposal, or that anyone shall refrain from <br />bidding; that the proposer has not In any mariner, directly or Indirectly, sought by agreement, <br />communication, or conference with anyone to fix the proposal price of the proposer or any proposer, or to <br />fix any overhead, profit, or cost element of the proposal mice, or of that of any other proposer; or to <br />secure any advantage against the public body awarding the contract of anyone interested in the <br />proposed contract; that all statements contained in the proposal are true; and, further, that the proposer <br />has not, directly or Indirectly, submitted his or her proposal price or any breakdown thereof, or the <br />contents thereof, or divutged information or data relative therelo, or paid, and will not pay, any tee to any <br />corporation, partnership, company association, organization, bid depository, or to any member or agent <br />thereof to effectuate a collusive or sham proposal, <br />Note; The above non.coilusfon affidavit Is part of the submitted proposal. Signing this proposal on the <br />signature portion thereof shall also constitute signature of this noncollusion affidavit, Proposers are <br />cautioned that making a false certification may subject the certifier to criminal prosecution. <br />Signed Irineo Nuno <br />Printed Name <br />State of California, County of San Bernardino <br />Subscribed and sworn to (or affirmed) before me on this day of. 20_„_,x,,,, by <br />having proved to me on the basis of satisfactory evidence to be the <br />person(b) who appeared before me. <br />Notary Public. Signature Notary Public Seal <br />THIS FORtJI tUUBT BE COMPUET5 ANDINCLUDE WITH THE PROP <br />PROPOSALS THAT DO NOT CONTAIN THiS FORM WILL BE CONSIDERED NO <br />Patio 44 <br />PD Janitorial Services RFP 17.022 <br />2501-90 <br />
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