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CITY OF SANTA ANA <br />ATTACHMENT D <br />NON -COLLUSION AFFIDAVIT <br />(Title 23 United States Code Section 112 and Public Contract Code Section 7106) <br />To the CITY OF SANTA ANA <br />In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the proposer <br />declares that the proposal is not made in the interest of. or on behalf of, any undisclosed person, <br />partnership, company, association, organization, or corporation; that the proposal is genuine and not <br />collusive or sham; that the proposer has not directly or indirectly induced or solicited any other proposer <br />to put in a false or sham proposal', and has not directly or indirectly colluded, conspired, connived or <br />agreed with any proposer or anyone else to put in a sham proposal, of that anyone ,shall refrain from <br />bidding-, that the proposer has not in any manner, directly or indirectly, sought by agreement, <br />communication, or conference with anyone to fix the proposal price of the proposer or any proposer, or <br />to fix any overhead, profit, or cost element of the proposal price, or of that of any other proposer, or to <br />secure any advantage against the public body awarding the contract of anyone interested in the <br />proposed contract; that ail statements contained in the proposal are true; and, further, that the proposer <br />has not, directly or indirectly, submitted his or her proposal price or any breakdown thereof; or the <br />contents thereof, or divuiged information or data relative thereto, or paid, and will not pay, any fee to any <br />corporation, partnership, company association, organization, bid depository, or to any member or agent <br />thereof to effectuate a collusive or sham proposal_ <br />Note: The above non -collusion affidavit is part of the proposal. Signing this proposal on the signature <br />portion thereof shall also corlStitutE? Sirl3tllre Of till o4lt1 lion affidavit. Proposers are cautioned that <br />makina a false certification may subiect the cert� � r to crin ina . <br />Sig <br />State of CaliforrkO� County of Orange <br />notary public or other officer completing this <br />certificate verifies only the identity of this individual <br />who signed the document to which this certificate is <br />,�f'hat dc­ w-•-- <br />Subscribed and sworn to (or affirmed) before me on this eday of March , 20 24 ,key <br />Luis Echeverry , proved to me on the basis of satisfactory evidence to be the persons} <br />who appeared before me. <br />Notary Pu,taffc Sign ture <br />COMM. #2378217 � <br />` vow E Nrat .ry Put lic Cal'dornia <br />� �w xtth:�tf� Orenge C„uniy -- <br />s M Comm. Emies Kcv. 1, 2025 <br />Notary Public Seal <br />THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. <br />PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. <br />RFP 24-022A City of Santa Ana Page 45 of 51 <br />