Laserfiche WebLink
DocuSign Envelop ID: 994D7Bg4-A6E8-44E9-13863-2D49AQ073F7A <br />-T L <br />ATTACHMENT D <br />NON -COLLUSION AFFIDAVIT <br />(Title 23 United States Code Section 112 and Public Contract Code Section 7106) <br />To the CITY OF SANTA ANA <br />In accordanoe wlth'fltle 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 in 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 manner, directly or indirectly, sought by agreement, <br />communication, or conference with anyone to fix the proposal price of the proposer or any proposer, or <br />to fix any overhead, profit, or cost element of the proposal price, 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 divulged Information or data relative thereto, or paid, and will not pay, anyfee 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 noncollusion affidavit Is part of the proposal. Signing this proposal on the signature <br />portion thereof shall also constitute signature of this noncollusion affidavit. Proposers are cautioned that <br />malting a false certiflgtlon may subject the certifier to criminal prosecution. <br />Stato of California, County of <br />Subsorlbed and sworn to (or affirmed) before me on this 28 day of May , 2020 , by <br />ro r], ed a , proved to me on the basis of satisfactory evidence to be the person(s) <br />who a pear before me. <br />Nolary VuUllo - ;It'0rnla <br />orongo 009nty <br />:' Com plaalan # 2109567 <br />M Comm. (ix lros An 13, 20 <br />Notar ublic Si nat0re Notary Public Seal <br />THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. <br />PROPOSALS'fHAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. <br />RFP Nb, 26-053 Video Surveillance System Maintenanco and Repair Services Page 38 of41 <br />