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05/02/2013 14:15 17607279332 POWERLUX CORPORATSCN PAGE 01/01 <br />EXHIBIT G <br />CITY OF SANTA ANA <br />REQUEST FOR PROPOSALS FOR LED POST TOP RETROFIT STREETLIGHTS <br />NONCOLLUSION AFFIDAVIT <br />NON - COLLUSION AFFIDAVIT <br />(Title 23 United States Code Section 112 and <br />Public Contract Code Section 7106) <br />To the GITY,OF SANTA ANA <br />In accordance with Title 23 United States Code Section 112 and Public Contract Code 7100 the proposer <br />declares that the proposal is not made In the Interest of, or on behalf of, any undisclosed person, partnership, <br />company, association, organization, or corporation; that the proposal is genuine and not collusive or sham; that <br />the proposer has not directly or indirectly induced or solicited any other proposer to put In a false or sham <br />proposal, and has not directly or indirectly colluded, conspired, connived or agreed with any proposer or <br />anyone else to put in a sham praposat, or that anyone shall refrain from bidding; that the proposer has not in <br />any mariner, 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 coat element of the proposal <br />price, or of that of any other proposer, or to secure any advantage against the public body awarding the <br />contract of anyone Interested In the proposed contract; that all statements contained In the proposal are true; <br />and, further, that the proposer has not, directly or indirectly, submitted his or her proposal price or any <br />breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not <br />pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any <br />member or agent thereof to effectuate a collusive or sham proposal. <br />Noke: The above noncolluslon affidavit Is part of the proposal. Signing this proposal on the signature portion <br />thereof shall also constitute signature of this noncollusion affidavit. Proposers are cautioned that making a <br />false certification may subject the certifier to criminal prosecution. <br />affirmed) before me. on <br />proved to me ni the <br />\AV I z,, <br />Notary Puloh Si6pature <br />PROPOSALS <br />XIAOFFI WU <br />Commission a 1985329 <br />Notary Public - California <br />L05 1100 as County <br />M .Comm. Ex 1 as, Au i 20.16. <br />Notary Public Seal <br />_, 20,, by <br />IM person(s) who <br />RFP FOR LED POST TOP RETROFIT STREETLIGHTS Page 125 <br />20B -21 <br />