Laserfiche WebLink
CITY OF SANTA ANA <br />PROJECT NOS. 11-6743 AND 11-6415 <br />PROPOSAL AND CONTRACT AGREEMENT <br />NON -COLLUSION AFFIDAVIT <br />(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 <br />BIDDER to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived <br />or 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 <br />fix any overhead, profit, or cost element of the bid price, or of that of any other BIDDER, or to secure <br />any 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 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 bid. <br />Note: The above Non -collusion Affidavit is pant of the Proposal. Signing this Proposal on the <br />signature portion thereof shall also constitute signature of this Non -collusion Affidavit. <br />BIDDERS are cautioned that making a false certification may subject the certifier to criminal <br />prosecution. i J� `�} <br />Signed I U/ If V 1 <br />State of Califhrhia <br />County of 5XW �G2N.g2/J�a/o <br />/Subscribed and sworn to (or affirmed) before me on this y/ day of Q,/ 20[3, by <br />A2?99 �h2/dr.GN%FA/ , proved to me on the basis of satisfactory evidenc�t`o e the person(s) <br />who appeared before me. <br />of Ru ignature <br />Notary Public Seal <br />BP 14 of 17 <br />TO BE INCLUDED IN BID PACKAGE <br />