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CITY OF SANTA ANA <br />PRWECT08-602k FAIRVIEW TRIANGLE HABITAT RESTORATION <br /> <br />[role 21 Uni(eA Sha[cs Code Section 112 and <br />PubGeConlracl Code S¢Gioo 7106) <br />To ?heCITY OFSANTA ANA DEPARTMENT OF PUBLIC WORKS <br />PROPOSAL AND CONTRAC7 AGREEMENT <br />NON-COLLUSION AFFIDAVIT <br />In accordance whh Tide 23 United SfM Cede Scefion 112 and WbBc ConEad Cede 71061he BIDDER <br />dcelmcs Thal the bid is not made'm [he'mleresf of, or on behalf of, any undisclosi person, partnership, <br />tympany, association, organization, or cotporadon; Thal the bid is genuine and riot collusive or sham, Ihal <br />the BIDDER has oat direGly or Indircefly induced or solicited any other BIDDER to put is a I'efse or sham <br />bid, and has riot dirutly or indiizclly colluded, conspired, connived er agreed wish any BIDDER or anyone <br />clsctopm in a sham bid,orThai anyoncshall refrain from bidding; Thal the BIDDER has aolin any manner, <br />dimGly or iwdirealy,sough! by agreement, commaoiralioo, or conference wish anyone to Gs the bid price <br />of the BIDDER orawyBmDER, or m Cu any overhead, profh, or cast elemewl of the bid pace, or of Ihal of <br />any other BIDDER, or to secure any advantage against to public body awarding the comrac[ of anyone <br />imeres9cd in fhc proposed mw[racl; ihw aft naiemenls contained in the hid are we; and, fonher, that the <br />BIDDER has not, diieGly er rodlmedy, submi[[ed his or her bid price or any breakdown thereof, or Ih¢ <br />coareaas Iherenf, or divulged information ordata relative thereto, or paid, and will not pay, any fee In any <br />oorporadoo, partnership, company asseuafion, orgaoi¢alion, bid depository, or m any member or agent <br />[hereof m effeclrmlea cellusive orsham bid. <br />Note: The above Nomcollusieo Affidavit Is pan of the Proposal. Signing Ibis Proposal on the <br />signatureponionihereofshallalsoconslitufesignamreoflhisNon-cellosiooAfGdavii. BfDDERS <br />arc wmioncd That making a fulserea4ficu[iow may subject ?heceni6er to criminal prosceution <br />Signed <br />Slam of California <br />Coonlyof dOf ?y?f?Pf <br />Subscribed and swum fe (or afhrmrd) before me en ibis $? day of , 2d I I by <br />? , proved to me on the basis o[ satisfactory evidence io b¢ the person(s) who <br />appcare fore me. <br />N. SHaH <br />? ?uM.k ISN181 ? <br />NOINYPVlIGGNONA <br />IGNIEIEI CgNiY ? <br />urm?.uo s?nr,wu <br />NolaryPublicSlgnalore NolarypublicSeal <br />TO BE INCLUDED IN BID PACKAGE <br />BP 12 of 31