Laserfiche WebLink
Appendix <br />ATTACHMENT 3-1: NON -COLLUSION AFFIDAVIT <br />CERTIFICATIONS <br />NON -COLLUSION AFFIDAVIT <br />(Title 23 United States Code Section 112 and <br />Public Contract Code Section 7106) <br />To the CITY OF SANTA ANA DEPARTMENT OF PUBLIC WORKS <br />In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 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, organization, or corporation; that the bid is genuine and not collusive or sham; that <br />the BIDDER has not directly or indirectly induced or solicited any other BIDDER to put in a false or sham <br />bid, and has not directly or indirectly colluded, conspired, connived or agreed with any BIDDER or anyone <br />else to put In a sham bid, or that anyone shall refrain from bidding; that the BIDDER has not in any <br />manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the <br />bid price of the BIDDER or any BIDDER, or to fix any overhead, profit, or cost element of the bid price, <br />or of that of any other BIDDER, or to secure any advantage against the public body awarding the contract <br />of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, <br />that the BIDDER has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or <br />the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to <br />any corporation, partnership, company association, organization, bid depository, or to any member or agent <br />thereof to effectuate a collusive or sham bid. <br />Note: The above Non -collusion Affidavit is part of the Proposal. Signing this Proposal on the <br />signature portion thereof shall also constitute signature of this Non -collusion Affidavit. BIDDERS <br />are cautioned that making a false certificationAnay subject the certifier to criminal prosecution. <br />Signed <br />State of California � 1 <br />Countyof5-art ve.CYlar In° <br />Sppbscribed and sworn to (or affirmed) before me on this A'11�1 day of 57�- , 20�� by <br />SlaL"• _ 1�i 4WICCSk i , proved to me on the basis of satisfactory evidence to be the personal who appeared <br />before me.' <br />Notary Public Signature <br />Notary Public Seal <br />aE'see raj o4achea( <br />ai <br />V RMd f+rX%>.ffr% <br />RFP NO: 204111 MATERIALS TESTING & SPECIAL INSPECTION SERVICES <br />