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NON•COLLUSION AFFIDAVIT <br />(Tifia 23 United States Code Section 112 and <br />Public Contract Code 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 declares <br />that the bid is not made In Ure hrterest of, or on behalf of, any undisclosed person, partnership, company, association, <br />organization, or corporation; that the bid Is genuine and not collusive or sham; that the BIDDER has not dircetfy 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 agmemerrt, <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 oftha 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, father, that fire BIDDER Iran 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 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 above Non -collusion Affidavit is part of the Proposal. Signing this Proposal on the signaturo <br />Portion thereof shall also constitute signature of this Nun-cullushm Affidavit. BIDDERS are cautioned that <br />making a false c5l0cation may subject the ocrdfrer to criminal prosecution. <br />Signed <br />State of8ailferaia I-t-ORrb <br />County of NiusBo Ro06H <br />ubseribedand swore to (or affirmed) before me on this day of Y'H 20 by <br />/KAt/ <br />before me. proved to me on the basis of satisfactory evidence to be the person(s) who appeared <br />*Notaryublic S=ignatum <br />+'�D�[4ti. CUWOIAHOSANG <br />i WCOMMISSIONNG01077 <br />y}+ elf EXPIRES: Odober1S, 2021 <br />*.,orf;q„` eordedtbnr NOtaYPAGcthdrm%n <br />Notary Public Seal <br />City of Santa Ana RFP <br />Page A3-1 <br />25A-66 <br />