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13 <br /> 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 certificati n may subject the certifier to criminal prosecution. <br /> Signed <br /> State of County of Orange <br /> Subscribed and sworn to(or affirmed)before me on this day of 20 25, by <br /> proved to me on the basis of satisfactory evidence to be the person(s) <br /> who appeared before me. <br /> R054IE I.ESC OON <br /> COMM. #24434O3 x <br /> zNotary Public.Callforrilir 7° <br /> Orange County o <br /> My Comm.Ex fires hta 29,242 <br /> Notary Public Signature Notary Public Seal <br /> THIS FORM MUST RE 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 />