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23B - PROJ - ROADWAY REHAB
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06/16/2015
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23B - PROJ - ROADWAY REHAB
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Last modified
6/11/2015 3:48:41 PM
Creation date
6/11/2015 3:30:35 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23B
Date
6/16/2015
Destruction Year
2020
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CITY OF SANTA ANA <br />PROPOSAL, <br />Project No. 14 -6801: McFadden Avenue from Newhope Street to Harbor Boulevard <br />Project No. 14 -6804: Civic Center Drive from Main to Spurgeon Street <br />Project No. 14 -6811: Memory Lane from Main Street to North City Limit <br />NON - COLLUSION AFFIDAVIT <br />(Title 23 United States Code Section 112 and <br />Public Contract Code Section 7106) <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, <br />connived or agreed with any BIDDER or anyone else to put in a sham bid, or that anyone shall <br />refrain from bidding; that the BIDDER has not in any manner, directly or indirectly, sought by <br />agreement, communication, or conference with anyone to fix the bid price of the BIDDER or any <br />BIDDER, or to fix any overhead, profit, or cost element of the bid price, or of that of any other <br />BIDDER, or to secure any advantage against the public body awarding the contract of anyone <br />interested in the proposed contract; that all statements contained in the bid are true; and, further, that <br />the BIDDER has not directly or indirectly, submitted his or her bid price or any breakdown thereof, <br />or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, <br />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 bid. <br />Signet <br />Note: The above Non - collusion Affidavit is part of the Proposal. Signing this Proposal on <br />the 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 <br />State of California <br />County of1_Li%17�i� <br />Subscribed and sworn to (or affirmed) before me on this day of � 2(��y <br />� t l � j� 1�.>a VV1l C g� proved to me on the basis of satisfactory evidence to be he person(s) <br />BP -12 <br />Notary Public Seal <br />23B -34 <br />55 anvaN°"'°" n srE n NsDN [ <br />+yCommlaeiorr # i956 O <br />UW - Notary Puhllo - Californla a <br />San Bernardino Counly <br />my Comm. Ea he Oct S. 2015 <br />
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