Agenda Packet_2022-05-03 - Laserfiche WebLink

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DocuSign Envelope ID:440EC5ED-7173-4C14-A8C2-CB4E1C47BF65 Appendix ATTACHMENT 3-1.NUN-COLLUSION AFFIDAVIT CERTIFICATIONS N_QN-00LL.I>15IQh A_FFIDAV1T (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY OF Sd`<NTA ANA DEPARTMEtv`T OF PUBLIC WORKS In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the BIDDER declares that the bid is act made in the interest of or on behalf ,cf, any Undisclosed person; partnership, company, association, org^aniZatiorl, or corporation; that the bid is genuine and not coilusive or sham; that the BIDDER has not directly Or indirectly induced or solicited any other BIDDER to put in a false or sham bid,and has not directly or indirectly cailuded,conspired,connived or agreed with any BIDDER or anyone else to put in a sham bid, or that anyone shall refrain fmm bidding; that the BIDDER Itas not in any manner, directly or indirectly, sought by agreement,communication,or conference with anyone to fix the bid price of the BIDDER or any BIDDER, or to fix any overhead,profit,or cost element of the bid price, or of that of any other 13MDER, or to secure any advantage against the public body awmrding the contract of anyone interested in the proposed contract;that all statements nntained in the hid are true;and, further, that:he 13E)DER has not,directly or indirectly,submitted his or her bid price or any breakdown thereof,or the contents thereof or divulged information or data relative thereto, or paid, and will not pay,any fee to any corporation, partnership,company association,organization,bid depository,or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above ?Jon-collusion Affidavit part of the Proposal_ Signing this Proposal on the signature portion thereof shall also consti Ftore of this-Non-collusion Affidavit. BIDDERS are cautioned that making a false certiFc i trt tir cc the certifier to criminal prosecution{ Signed State of California County of CA Subscribed and swam to (or affirmed) before me on this 7 day of Few 202Z by Carlos Galaviz-WatA[y Public proved to nee on the basis of satisfactory evidence to be the person{,s}who appeared before me. CAAC45 G,ALAVIZ Hctarp Pubile•CaVornla a•r to%AnVles ruuety .a r Onnmissipn @ 224537t my Comm,Expires Jun 1,24322 ataxy Public S!g&iLit Notary Public Seal City of Santa Ar>a 1�FP Pane AM   City Council  22– 181 5/3/2022