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Non - Collusion Affidavit (Title 23 United States Code Section 112 and <br />Public Contract Code Section 7106) <br />To the CITY OF SANTA ANA DEPARTMENT OF PUBLIC WORKS <br />In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the <br />bidder declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, <br />Partnership, company, association, organization, or corporation; that the bid is genuine and not <br />collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder <br />to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived or <br />agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from <br />bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, <br />communication, or conference with anyone to fix the bid price of the bidder or any bidder, or to fix <br />any overhead, profit, or cost element of the bid price, or of that of any other bidder, or to secure any <br />advantage against the public body awarding the contract of anyone interested in the proposed <br />contract; that all statements contained in the bid are true; and, further, that the bidder has not, <br />directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents <br />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 <br />agent thereof to effectuate a collusive or sham bid. <br />Note: The above Non - collusion Affidavit is part of the Proposal. Signing this <br />Proposal on the signature portion thereof shall also constitute signature of this Non - <br />collusion Affidavit. Bidders are cautioned that making a false certification may <br />subject the certifier to criminal prosecution. <br />Signed <br />Subscribed and sworn to before me this <br />- 1,4 tfr. day of <br />Signed <br />Notary Public <br />Notary Seal: <br />LIAR 4� [ <br />COMmk lao 11"IftV s <br />I! " W "� <br />