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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 <br />proposer declares that the proposal is not made in the interest of, or on behalf of, any undisclosed <br />person, partnership, company, association, organization, or corporation; that the proposal is <br />genuine and not collusive or sham; that the proposer has not directly or indirectly induced or <br />solicited any other proposer to put in a false or sham proposal, and has not directly or indirectly <br />colluded, conspired, connived or agreed with any proposer or anyone else to put in a sham <br />proposal, or that anyone shall refrain from bidding; that the proposer has not in any manner, <br />directly or indirectly, sought by agreement, communication, or conference with anyone to fix the <br />proposal price of the proposer or any proposer, or to fix any overhead, profit, or cost element of <br />the proposal price, or of that of any other proposer, or to secure any advantage against the public <br />body awarding the contract of anyone interested in the proposed contract; that all statements <br />contained in the proposal are true; and, further, that the proposer has not, directly or indirectly, <br />submitted his or her proposal price or any breakdown thereof, or the contents thereof, or divulged <br />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 <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 <br />signature portion thereof shall also constitute signature of this non -collusion affidavit. Proposers <br />are cautioned that making a false certification may subject the certifier to criminal prosecution. <br />Signed <br />State of . County of <br />Subscribed and sworn to (or affirmed) before me on this day of <br />20 , by , proved to me on the basis of satisfactory evidence to <br />be the person(s) who appeared before me, <br />SEE ATTACHED <br />NOTARIAL CERTIFICATE <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 <br />NONRESPONSIVE. <br />City of Santa Ana RFP No. 25-019A Page 68 of 101 <br />