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MY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.; 14-6802 WARNER AVENUE STREET IMPROVEMENTS (MAIN TO OAK) <br />PROJECT NO.:18-6424 WARNER AVENUE WATER MAIN IMPROVEMENTS (MAIN TO OAK) <br />PROJECT NO.: 20-6618 WARNER AVE STORM DRAIN IMPROVEMENTS (MAIN TO OAK) <br />TION-COLLUSION AFFIDAVIT <br />(Title 23 United States Code Section I 12 and Public Contract Code Section 7106) <br />In conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the <br />BIDDER declares that the bid is not made in the interest of, or on behalf of, any undisclosed <br />person, partnership, company, association, organization, or corporation; that the bid is genuine and <br />not collusive orsham; thatthe BIDDER has not directly or indirectly induced or solicited any other <br />BIDDER to put in a false or sham :Sill, and has not directly or indirectly colluded, conspired, <br />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 <br />agreement, communication, or conference with anyone to fiat the bid price of the BIDDER or any <br />other BIDDER; or to Ex any overhead, profit, or cost element of the bid price, or of that of any <br />other BIDDER, or to secure any advantage against the public body awarding the contract of anyone <br />interested in the proposed contract; that ail statements contained in the bid are trite; and, further, <br />that the BIDDER has not, directly or indirectly, submitted his or her bid price or any breakdown <br />thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will <br />not pay, any fee to any corporation, partnership, company association, organization, bid <br />depository, or to any member or agent thereof to cffectuato a collusive or sham bid. <br />Note, Xhe above Non -collusion Affidavit is part of the Proposal. BIDDERS are cautioned <br />iat i false certification may suhect the certifier to criminal prosecution. <br />Signet} <br />State of California m <br />County of cif atct <br />Subscribed and sworn to (or affirmed) before me on this '2 rC day of 6r u� 20.1( by <br />,proved tome on the basis of satisfactory evidence to be the persnn(s) <br />who appeared before me <br />Notary Public Signature Notary Public. Seal <br />P-17 ofP-23 <br />