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CITY OF SANTA ANA <br />RF.P NO-- 22-153 <br />ON -CALL E MIGIN EERIN is DES I C N :5 ERVICES FOR PFAS TR EATMF_NT SYSTE MS <br />NON-COLLUSiON AFFIDAVIT <br />(Tille 23 t- need States Cade Section 112 a n d Pu blic Cenlraut Code Section 7 t 06) <br />In conformance with Title 23 United States Code 3ectioo 112 and Priblic Contract Code <br />711he B I DOER dPlanes that the bid is riol rrla de in the inle rest of, or ern behalf of, any <br />U rhdisdused persoh, partnersh i a, company, association, or-gan ization, or corporation; thal <br />the bid is gan uine a nd not ooliu siVIR or :511am; Mal the Bl DDE R has not d irerllyr o r indirectly <br />induced or solicited any other BIDDER to put in a false or sham hid, and has not directly <br />or indirectly colluded, conspired, connived, or agreed with aq MDER or anyone eke to <br />put in a S iam hld, or that anyoa-e sh011 reffain from bidding; that the 81DOER ha& nol In <br />aDy maDner, directly or indirec y, sought by agreement- communiwtlon, or nferenoe <br />with anyone to fix the bM pri-ce of we BIDDER or any other SIMER, or to fix any <br />overhead, profit, or cos! element of the bud price, or of that of any other' BIDDER, or to <br />secure any advantage against the public budy :Rwa{dIng the contract of anyone iDterestL-d <br />in the proposed conicact, that all Statements conlained in tba bid are tfue, and, further, <br />t#ial the BIDDER has no#, directly or lndireullyr, srjhrnitted his or her bid price or any <br />breakdown th7 einf, or the contents lhereof, of d ivu�ged informaWn or data ra Istive <br />therelo, or paid, Bind will not pay, any fee to any corporation, partnership, cornpany <br />association. organizatGan, bid deposilory, or to any rriembef or agent Ih1-ereof to effectuate <br />a call as ive or sham bid. <br />Note- The above Noll lluSlon Affidavit is part of the Proposal. $I0t}ER:5 are <br />cauthoned that making a false certification mi3y subjeet the certifier to <br />chminal prosecution. <br />Signed <br />State of California <br />CoUnty of /F�94'r`'Lh <br />ubscd ed artd sworn to (OF affirmed) before me on this �day of� z y <br />9tj,�0 - proved to me on the basis of safisfaclory evidence to be <br />the person(s) who appeared before r <br />SEE NOTARY <br />z4e4l'ae� A7'TACHE [) <br />Notary Public Signature Notary PI.Jb lid. Seal <br />Gi[y of Santa Ana #�P 2_2433 <br />Gn-Gal En Bring Deeigrr Seryices for PFAS Twenerrt SYsrems <br />P:39a �$ <br />