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CITY OF SANTA ANA
<br />RFP NO.: 23-014
<br />CONSUMER CONFIDENCE REPORT (CCR) AND AUXILIARY SERVICES
<br />NON -COLLUSION AFFIDAVIT
<br />(Title 23 United States Code Section 112 and Public Contract Code Section 7106)
<br />In conformance with Title 23 United States Code Section 112 and Public Contract Code
<br />7106 the BIDDER declares that the bid is not made in the interest of, or on behalf of, any
<br />undisclosed person, partnership, company, association, organization, or corporation; that
<br />the bid is genuine and not collusive or sham; that the BIDDER has not directly or indirectly
<br />induced or solicited any other BIDDER to put in a false or sham bid, and has not directly
<br />or indirectly colluded, conspired, connived, or agreed 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 conference
<br />with anyone to fix the bid price of the BIDDER or any other BIDDER, or to fix any
<br />overhead, profit, or cost element of 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
<br />in the proposed contract; that all statements contained in the bid are true; and, further,
<br />that the BIDDER has not, directly or indirectly, submitted his or her bid price or any
<br />breakdown thereof, or the contents thereof, or divulged information or data relative
<br />thereto, or paid, and will not pay, any fee to any corporation, partnership, company
<br />association, organization, bid depository, or to any member or agent thereof to effectuate
<br />a collusive or sham bid.
<br />Note: The above Non -collusion Affidavit is part of the Proposal. BIDDERS are
<br />cautioned that making a false certification may subject the certifier to
<br />criminal.nrosecLkgQn, r,
<br />Signed
<br />State of Calif 7'..f
<br />ia - J
<br />County of i_.r � t
<br />Subscribed and sworn to (or affirmed) before me on this i day of �_ V 20 y
<br />proved to me on the basis of satisfacto*evfdence to be
<br />the personal who appeared beforepie,
<br />Nola Publi r Si n ture [ Notary Public Seal
<br />y fel �g INS, rdl` ate re uxasw t�rcale is
<br />f R notary Yp�oi.c or WWI oH�O! �p Sbe 4bc?Irrirrtly wT"r%" 1
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<br />r.:.. i 1 , % suedY nefd v f }
<br />N, 41'V -Iside -Cou"' If Vf� r �Cril7gd nd sworn l6 {vr a � 1 1� ✓ ���� iQ, Yam' tlrrr-i SiSSt'County
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<br />City of Santa Ana RFP 23-026:--
<br />Consumer Confidence Report (CCR) and i�ixiliary Se�ices
<br />Page 32
<br />City Council 22 — 127 _ 7/18/2023
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