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CITY OF SANTA ANAr <br />RFP NO : 22-133 <br />ON -CALL ENGINEERtNG DESIGN SERVICES FOR PFA,Fr TREATMENT SYSTEMS <br />NON-CCI-LUSION AFFIDAVIT <br />{Title 23 united States Code Section 112 and Public Contract Code. Section 7106) <br />In conformance with Trtle 23 tlniled Stales Code Section 112 and Public Contract Code <br />7106 the BIDDER declares that toe bid is not made in the interest of, or on behalf of, arty <br />unditlosed person, parinership, company, association, organization, or corporation; that <br />the bid is genuine and nol collusive or sham that the BIDDER has notdirectly or indirectly <br />induced or solicited any other 91DDER to put in a [also or sham bid, and has not directly <br />or indirectly corluded, crsnspfred. Connived, oragreed with any BIDDER or anyone else to <br />put in a sham bid, or that anyone shall refrain from bidding, that the BIDDER has not in <br />any manner, directly or indirectly, sought by agreement, communication, or confereriCd <br />with anyone to fix the bid price of the BIDDER or any other BIDDER, or to fix any <br />overhead, profil, or cost element of the bid price. or of that of any other 8110DER or to <br />secure any advantage against the public body awarding the contract of anyone interested <br />Irk the proposed Contract; that ali statements contained in the bid are true; and, further, <br />that the BIDDER has nol, directly of indirectly, submitted his or her bid price or any <br />breakdown thereof, or the contents thereof. or divulged inforrnalion or data relative <br />thereto, or paid, and will not pay, any fee to any corporation. partnership, company <br />association, organtzabDn, bid depository, or to any member or agent thereof to effectuate <br />a collusrv$ of sham bid. <br />Able: The above Non-D[Musion Affidavtl is part of the Proposal. BIDDERS are <br />cavliDned that making a false Certification may subject the cerlFfier to <br />criminal proseewiOn. <br />Signed 1' — — <br />State of California <br />County of -'Z— <br />Subscribed and swam !o (or affmneda before me on This 15 day cr bee 20-U, 6y <br />0o c,V , proved to me on the basis of saNtfactory evidence to be <br />the person(s) who appeared before me <br />c.-t <br />NnlaryVublic Signature Notary Pu4lic Seal <br />rbeui ktHE , QHrWnY <br />� � drayria.rrry _ <br />IPP60I M1546 <br />+fr io-*m �syra4 `U a:r, M1 <br />City of Santa Ana RFP 22-133 <br />On -fall E"ineering Design Serwice$ for PFA$ trealift+t Sysle^s <br />Pane 36 <br />City Council 19 — 276 4/4/2023 <br />