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FULL AGENDA PACKET_2021-03-16
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FULL AGENDA PACKET_2021-03-16
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City Clerk
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Clerk of the Council
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3/16/2021
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Appendix <br />ATTACHMENT 3~1: AFFIDAVIT <br />CERTIFICATIONS <br />NON -COLLUSION AFFIDAVIT <br />(Title 23United States Code Section 112mW <br />Public Contract Code Section 7106) <br />7othe CITY 0PSANTA&M&DEPARTMENT 0[PUBLIC WORKS <br />In accordance with Title 23 United States Code Bcudoo 112 and Public Contract Code 7106 the BIDDER <br />declares that the bid ianot rnade in the interest of, mon behalf of ��undisclosed person, partnership, <br />companassociation,cnmpunassociation, organization, or n; that the hid is genuine and not ud|uoi`e or sham; that <br />the BIDDER has not directly or indirectly induced or solicited any other BIDDER to put in ofa|uc or mhom <br />bid, and has not directly orindirectly colluded, conspired, connived or agreed with any BIDDER *ranyone <br />clue /o put in u ubum hid, or that anyone shall refrain from bidding; that the 87DU8R has not in any <br />manner, directly or indirectly, uought hyogmrmcn\ communication, orconference with anyone to fix the <br />bid price nfthe BIDDER or any 8|DDCK or to fix any overhead, pnuD|, orcost element n[the bid price, <br />orofthat nfany other BIDDER, or to secure any advantage against the public body awarding the contract <br />of anyone interested in the proposed xnnknd; that all gatmneob contained in the bid are true; and, further, <br />that the BIDDER has not, directly or indirectly, submitted his orher bid price orany breakdown thereof, or <br />the contents thereof, or divulged inJbnno|ion ordata relative thereto, or paid, and will not pay, any fee (o <br />any corporation, partnership, company association, organization, hid depository, orioany member or agent <br />tborrofineffectuate acollusive nrsham bid. <br />Note: The above Non -collusion Affidavit is part of the Proposal. Signing thisthe <br />signature also constitute signature of this Non -collusion Affidavit. BIDDERS <br />are cautioned that making ufalse certification may subject the certifier Wcriminal prosecution, <br />Signed <br />State of California <br />County oflla(L�ZLIPO <br />Subscribed and sworn to (oro��� beforemo onthis�� day of 20?� by <br />proved to me on the basis ofsatisfactory ��nce to be the persor(s)nho appeared <br />before me. <br />I W,JANICE GIL I DEN REHAK <br />Orange County <br />�/q My COMM, Expires July 13, 2023 <br />fA <br />Notary Public Signature Notary Public Sea] <br />City ofSanta Ana RFP <br />City Council <br />3/16/2021 <br />
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