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CITY OF SANTA ANA <br />RFP NO.: 22.153 <br />OWCALL B NGIN EERING OES 10 N SERVICE S FOR PFAS TREATMENT SYSTEMS <br />N0N:9P&LVMQN AFFIDAVIT <br />t(Tille 23 United States CadeSection 11,2 and PON to Cont(acl Code Section 7 106) <br />In conformance with Title 23 United States Cqdle Section '112 and Pti We Contract 'Code <br />71106 the HI DDER doGlares that the bid is not made In (lie Inle rest of, ,or on behalf or. any <br />undisclosed person, partnership, company, ess"lalion, organization, orcorporabon; that <br />the bid Is gorrulne and not collusive or sh,am; III at the B1 DDE R has not directly or indirectly <br />Induced or BoIllofted any other BIDDER to put in a false or sham bid, and has not directly <br />or Indirectly colluded, conspired, connived, at agreed with any BIDDER or anyone else to <br />put In a sham bid, nor that anyona shall refrain from bidding; that the BIDDER has root In <br />any rrmnner, clkectly or Indirectly, sought by agreement, coat manicatlon. or oonfarence <br />%Wth anyone to fix the bid price of the BIDDER or any other BIDDER, or to fix any <br />overhead, profit, or cost element or the ;bW price, or of .that of any other HIDDER, or to <br />seatroany aadwantrage attaintat the ptublkc body awaaling the contract of anyone Interested <br />In Ilse proposed contract; that all statements conlolned In the bid are (fue, and, further, <br />that the BIDDER has not, dlmcffy or Indirectly,, submittod his or her bid price or any <br />break4myn thereof, or the contents thereof, or divulged Infottyiegon or data relative <br />thereto, or paid, and will not pay, any fee to, any wrporalton, partnership, company <br />association, organizattron, Wdepoollary, or to any member or agent thereof to effectuate <br />a collusive or sham, Wd. <br />Note. The above Non-collusian,.Affldavll Is park of the Proposal, BIDDER$ are <br />cautfoneil that making a false Gertification may subject they certifier to <br />Signed <br />State of 0011rorlila <br />County of S XV0'6k#L-- <br />S=tibscii "and sworn to (or affirmed) before me on this yleday of&/AVg&-6' 2V-2,-by <br />n0a to be <br />proved to me on Ilia basis or salisractory evIde <br />theperson(s) who appeared before me <br />10 SEE NOTAPtY <br />17 ATUCHST) <br />Notary Public Signature Notary Public. Seal <br />01y OC Santa Ana Rr P 22.133 <br />OJI-COM rNOW086M9 09910h; Servioss liar WAS TMgInjenj SyLgern-a <br />PE190 38 <br />