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A CERTIFICATIONS A"I"XACI )Vl EW 34, NON 69 LIJSION G'Ct i0d CGStTSI SCATI(>NS. (Title 23 United States Code segticri 112 and Public Contract Code Section 7106) TO the CITY OF SANTA ANA DEPARTMENT OF PUBLIC WCIRICS In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the BIDDER declares that the bid is not made in Cie interest of, or onbehalf of, any undisolosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham, that the BIDD R lies not directly or Indirectly induced or solicited olry other BIDDER to put in a false or sharp bid, and has not dlrootly or indirectly colluded, conspired, oonnlved or agreed with any BIDDER or anyone also to put in a sham bid, or that anyone shot] refrain prom bidding; that the BIDDER has not in any manner, directly or Indirectly, sought by ngr"Ment, communication, or conibrenee with anyone to fix the bid price of tine BIDDER or any BIDDER, or to fix any overhead, profit, or cost element of the bill price, or of that of any other BIDDER, or to secure any advantage against the public body awording the eonfxaot of anyone interested In the proposed eonttac that all statements contained In the bid me true; and, tlndhar, that the BIDDER has not, directly or indirectly, submitted be or her bid price or any breakdown tbercot or the contents thereof; or divulged information or data relative thereto, or Judd, and will not pay, my fog to any corporation, portnership, eonnpatny association, organization, bid depvahonq, or to any member or agent thereof to effootuatc a collusive or sham bid Note! The above lion-calluslon Affidavit is part of the Proposal. Signing ibis Proposal on the signature portion thereof shall also constitute signaiure of this Non-collosion Affidavit. BIDDERS are cautioned that uml ngafalseoartifleationmayisjubicctthecertifiertocriminalprosecution, Signed-,f��f%l%�Aj%1J' state of California county of --- Subscribed and sworn to (or 'affirmed) before me on this day of _...,.__., 20_,, by proved to me on the basis of satisfy y evidence to be are person(s) who appeared beforebafore Mo. 5'�� /�7'Cf1tt-G�17 Notary Public Seal Page A3.1 its;: Sx�