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FULL AGENDA PACKET 2021-06-15
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FULL AGENDA PACKET 2021-06-15
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7/19/2021 10:12:11 AM
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City Clerk
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Agenda Packet
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Clerk of the Council
Date
6/15/2021
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Appendix <br />ATTACHNIENI' 4-1: NON -COLLUSION AFFIDAVIT <br />CERTIFICATIONS <br />NON-COI.I.LSION All IDAVII <br />(Title 2; Unitcd Suites Code Section 112 and <br />Public Contact Code Section 7106) <br />IMI'MiShI 91MOM21MMF_\67q 911t�iiei��li�7�•lUe3rlCt�4�t17Nt(.7 <br />In accordance with Title 23 United Static Code Section 112 and Public Contract Code 7100 the BIDDER <br />declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, <br />company, association, organisation, or corporation; that the hid is genuine and not collusive or .Sham; that the <br />BIDDF,k has not directly or indirectly induced or solicited Lilly other BIDDER to put in a lake or sham bits, <br />and has not directly or indirectly colluded, conspired, connived or agn-eed with any BIDDER or anyone else <br />to put in a sham bid, or that anyone shall retrain from bidding; that the BIDDER has not in any manner, <br />directly or indirectly, sought by agreement. communication, or conference with anyone to fix the bid price <br />of the BU)DLR or any BIDDER, or to fix any overhead, profit, or cost element of the bid price, or of Gil of <br />any other BIDDER, or to secure any advantage against the public body awarding the contract of anyone <br />irncrestcd in the proposed contract; that all statenients contained in the bid arc ltuc; and, fLathcr, that the. <br />BIDDER has not, directly or indirectly, Subit>iucd his or her bid price or any breakdown thereof, or the <br />contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to ally <br />corporation, partnership, company association, organization, hid depository, or to any member or agent <br />thereof to effectrkne it collusive or sham bid. <br />Note: The above. Non -collusion Affidavit is part of the Proposal. Signing this Proposal on the <br />signature portion thereul'shall also amstiuue signature of this Non -collusion AffidavitBIDDERS <br />are cautioned that making a f Ilse certi ficatioil may subject the certifier to crinnina] prosecution. <br />Signed <br />State of California <br />County of <br />)ubscribcd and sworn to (ur off tool) before me an this clay of 20 , by <br />proved to me on the basis of satisthetory evidence io be die per,on(s) who appeared <br />before Inc. <br />Notary Public Signature Notary Public Seal <br />City Council City of Santa Ana -2(3&9 6 202 <br />Page A4-1 <br />
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