Laserfiche WebLink
c" CITY 4F 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 Z= <br /> State of CA. , County of N G E <br /> Subscribed and sworn to(or affirmed) before me on this day of 20 , by <br /> proved to me on the basis of satisfactory evidence to be the person(s) <br /> who appeared before me. <br /> <<r`ATr^"'-') C€6TIFICATe <br /> Dal-., IT IN)TIMS —, <br /> Notary Public Signature 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 25-02 7 Page 36 of at <br /> 11 <br />