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CITY OF SANTA a4NA <br />RIPP NO.:22mt33 <br />ON -CALL lgAltalNFERING DESIGN SENVIC'ES FOR PFAS TREATtw ENT SYSTEMS <br />11LON-COWUMN AFFIDAVIT <br />(Title 23 United States Code Section 112 and Pubtic Contract Code Sectlon 71106) <br />In conforrriance with Title 23 United States Code Section 1 t2:and f'u'blir Contract Code <br />7106 Ili;a'glpi©ER declares that the laid Is not niad'o in the interest of, or on behalf of, any <br />undisclosed person„ padneralitp, company, association, organtzation, rarco�rporatlan; deal <br />the bid Is genuine and not collusive or shanr; that lire BIDDER has, not directly or indirectly <br />Induced or solicited any other fTlC DER to ,prat In s false or shame bkl, and has not directly <br />or indlrortly ,rol.lwdad, coiispffie(f, crallrliweel, oragreed with any BIDDER or anyone else to <br />Put In a steam bid, or Mat anyone shall refrain troin bfdding, that: the BIDDER has not far <br />awry manner, directly at Indirectly. sought by acgreament, cwrinnuirlcation, or conference <br />with anyone to 'fix, the bid ,price of the BIDDER or ,any other BI:BCEB;„ or to fix any <br />ovorlioad, profit, or cost element of the bidprim or of that of any curer BIDDER, or to <br />secure any advantage against the public body awarding Ilia contract of Anyone Interested <br />In the proposed contract; that all staterrrents contained In the add are true; and, furtiaer, <br />that the BRIDER has viol, directly or Indlrectly, submilled his or' her bid price or ,any <br />broarkdo wn thereof, or the contents thereof. or divulged In'fiorination or data relative <br />thereto, or paid, and will not pay„ any Foe to any corporation, paitnarshIp, conip,any <br />association, organization, bld depository, or to any member Of agent thereof to off€actarate <br />a i crllus iare or abaarn tald. <br />Ffote. The above Nonaooilusion Affl¢lavit Is park of the Proposal. 1 IDDERS .are <br />ca010ne41 that snaking ;u false cartftication may sgatrjecl Ikea certifier to <br />crirntaiarl proKcvtiorl, <br />Signed <br />$tato of California . <br />counly of1 <br />Subscribod and swo€or affirnred) before me an this day o�trba�w, 282_, by <br />n <br />rk- , proved to one on the basis Hof satisfactory evidence to be <br />Ilia ;person(s) who appeared Ibefore rife <br />i <br />Molar Publio Signature Notary Public Seal <br />rarc+wt�rvna�a�'tea <br />dri n;euc � Fel�rnrnl3 <br />�� fjr;fir. €SLt,ry <br />tanrirrraar s to SrHt, <br />*�i'M'y €cwim C�grrH Fir aa, h32f <br />Gily Of Sante Ana RFP 23.133 <br />On -Coif C-giriearirig Design Sarwisas fern P PAS Troatownt Sy-Wim <br />Page 38 <br />