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CITY OF SANTA ANA <br />A"i'TAOHMENT D <br />NON.COLLUSION APFiDAVlT <br />(Tube 23 Uriited States Code Section 112 and Public Contract Code Section 7106) <br />To the CITY OF SANTA ANA <br />In amrdanoe mth Titm 23 United States Code Section 112 and Public Contract Code 7')06 the proposer <br />dealareS that the proposal iS net made in the intereSt Of, Or On behalf Of, any undi8Cl08ed perSOn, <br />partnership, (,mpany, association, organization, Or corporation; that the proposal is genuine and not <br />mllusive or sham; that the proposer has not directly or indirectly induced or solicited any other proposer <br />to put in a fa)se 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, or that anyone shall refrain from <br />bidding; that the proposer has not in any manner, directly or indirectly, sought by agreement, <br />oommunication, or conference with anyone to fix the proposal price of the proposer or any proposer, or <br />to % 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 />prpposed contract; that all statements contained in the proposal are true; and, further, that the proposer <br />has not, diredly or i@airect(y, submRted his or her proposal prioe or any breakdown thereof, or the <br />oontents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any <br />oorporgtion, partnership, company association, organization, bid depository, or to any member or agent <br />tfareof 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 />portin thereof shall also constitute signature of this non-collusion affidavit. Proposers are cautioned that <br />mmng a false certification may subject the certifier to criminal prosecution. <br />Subsmbed and swom to (or affirmed) before me on thi day of , 20 , by <br />Wll, 4t 0, ,ore me. , proved to me on the basis of satisfactory evidence to be the person(s) <br />Notary Publm Signature <br />D(14' as"W"rX'ice(l:":N"alcTslRtS' ,,C"" a <br />Notary Public Seal <br />THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. <br />PROPOSALS THAT DO NOT CONTAIN TH18 FORM WILL BE CONSIDERED NONRESPONSIVE. <br />C%drmbJ4rb RFP No. 25-027 PaHe36of4i <br />11 <br />  <br />  <br />City Council 20 – 35 4/15/2025