Laserfiche WebLink
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, or 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 all 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 divulged 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 constitute signature of this non-collusion affidavit. Proposers are cautioned that <br /> making a false certification may subject the certifier to criminal prosecution. <br /> Signed '- 7 �`���A <br /> State of CA County of Los Angeles <br /> Subscribed and sworn to(m affrmed) before me on this day of 2t-S b <br /> 1YL\ Pam+ f.0 C.AN DJ� , proved to me on the basis of satisfactory evidence to be the persor <br /> who appeared before me. <br /> JEFE HERGESHENER <br /> 'r Hoary Public•Cal llornla ■ <br /> s - EOS Angeles County C <br /> J Commission 0 2420805 <br /> My Comm.E-?lres Nov 0,2026 <br /> Notary Public Sipat4e 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 /> City of Santa Ana RFP No.24-102 Page 28 of 31 <br />