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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 proposed <br />contract; that all statements contained in the proposal are true; and, further, that the Proposer has not, <br />directly or indirectly, submitted his or her proposal price or any breakdown thereof, or the contents thereof, <br />or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, <br />partnership, company association, organization, bid depository, or to any member or agent thereof to <br />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 />W <br />State of 6A County of Orange <br />Subscribed and sworn to (or affirmed) before me on this \ s ! day of NA -!i , 20 "ZS, by <br />Y ev�v. UQ c�,A--so v1 proved to me on the basis of satisfactory evidence to be the person(s) <br />who appeared before me. <br />ROSALIE 1. ESCANDON <br />COMM. #2448403 z <br />a Notary Public • California <br />Z Orange County O <br />Comm. Expires May 29,20214 <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 25-050 Page 37 of 40 <br />