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APPENDIX <br />ATTACHMENT ATTACHMENT 3-1: NON -COLLUSION AFFIDAVIT <br />CERTIFICATIONS <br />CITY OF SANTA ANA <br />REQUEST FOR PROPOSALS <br />FOR <br />FOUNTAIN NIAINTF,NANCE <br />RFP NO.: 21-102 <br />NON-COLLt1SIQNAF IDAVI'1' <br />(`title 23 United States Codc Section 112 and <br />Public Contract Code Section 7106) <br />To the CITY OF SANTA ANA PARRS, RECREATION AND COMMUNITY SERVICES AGENCY <br />In accordance with Title 23 United States Code Section 112 and. Public Contract Code 7106 the BIDDFR declares that the bid <br />is not made in the interest of, or on behalf' of, any undisclosed person, partnership, company, association, organization, or <br />corporation; that the bid is genuine and not collusive or sham; that the BIDDER has not directly or indirectly induced or solicited <br />any other BiDDFR to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived or agreed with <br />any BIDDER or anyone 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 bid price of the <br />BIDDER or any BIDDER, or to fix any overhead, profit, or cost element or the bid price, or of that of any other BIDDER, or to <br />secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all <br />statements contained in the bid are true; and, further, that the BIDDER has not, directly or indirectly, submitted his or her bid <br />price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not <br />pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent <br />thereof to effectuate a collusive od*adbid. <br />Note: The above Non-e sion Affidavit is part or the Proposal. Signing this Proposal on the signature portion thereof <br />shall also constitute si lure of this Non -collusion Affidavit. BIDDERS are cautioned that making a false certification <br />may subject the cent • to criminal prosecution. <br />Signed <br />This form must be signed above This form must also be notarized for Public Works contract,& <br />State of California <br />County of_)A__._ <br />* $dr+ *I-'r4V 're %% <br />Subscribed and sworn to (or affirmed) before me on this ` day of , 20_, by _ proved <br />tome on the basis of satisfactory evidence to be the person(s) who appeared before me. <br />Notary Public Signature Notary Public Seat <br />rr <br />....Gity-of-Santa-Ane RFR21-102 <br />Page 29 <br />