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Appendix <br />.:.ATTAC.H..M.ENT 3-1e NO -COLLUSION AFFIDAVIT <br />['Ii:R IFIC.ATIO.NS <br />NON -COLLUSION AFFIDAVIT <br />(Tine 23 Un.itLd States Code ,Section 112 and <br />Public Contract Code Section 7106) <br />'I`o the CITY C)F SAN1'A ANA DEPAWI'Iv1EN Y OF PUBLIC: WORKS <br />In accordance with 'T'itle 23 United States Code Section 112 and Public Contract Code 7106 the J31D1.)L <br />declares that the: bid is not made: in the hiterest of, or on bel,iailf of any undisclosed person, partnership, <br />company, association, organization, or corporation; that the bid is go=i aloe and not collusive or sham; that the <br />BIDDER. has not directly or indirectly induced or solicited any other BIDDER to put in a Iaalse or sham bid, <br />and has not directly or indirectly colluded, conspired, connived or agreed with any BIDDER or anyone else <br />to put in a sham bid, or that anyone shall refrain front bidding; that the BIDDER has not in any manner, <br />directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price <br />of the BIDDER orany BIDDER, car to fix any overhead, profit, or cost element of the laid price., or of that of <br />any other BIDDER, or to secure any advantage against the public body awarding the contract of anyone <br />interested in the, proposed cc-)ntract, that all statements contained in the bid are true, and, :further, that the <br />BIDDER has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the <br />contents thereof, or divulged irtformaation 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 argent <br />thereof to effectuate a collusive or 5haarn Diet. <br />Norte, The above Non -collusion Affidavit is paarL of the Proposal. Signing this Proposal on the <br />sig iature portion thereof shall also constituhi signature of'this Nan -collusion Affidavit. BIDDERS <br />are cautioned that naaling lse certificatior nljaay subjeet the certifier to criminal prosecution. <br />Signed <br />State of California <br />County of Los Angeles <br />SUbscr.ibc d and sword to (car- affaraaae d) before nx on this � U , , day of tR is L, , 20 2 , by <br />roved to one on the basis of saatisl°rac,tor o.vrcicrruc. to be the er°son(a. <br />._u.�..__.�......_.__------.__._.__............. who a:Rlcared <br />before rrie. <br />Notary Pub:l..ic gnaiture <br />Sc•:° r ALICIANGUYEN <br />. Sys Notary Public California <br />_ = Las Angeles County <br />Commission 4 2375906 <br />Y My Comm. Expires Sep 23, 2025 <br />�1 <br />Notary Public Seal <br />City of Santa Ana RFP 21-095 <br />Page A3-1 <br />