Laserfiche WebLink
4. I CERTIFICATIONS <br />- ---- - ------ <br />APeerltaas <br />ATTACF1Ni1"sNT3-1: NON-COLLUS10N AFFIDAVIT <br />CERTIFICATIONS <br />CITY OF SANTA ANA <br />REQUEST FOR PROPOSALS <br />FOR <br />I3ItlTaGE PREVENTIVE MAIN?RNANCE P RO61RANI <br />IM'N0.: H-04^, <br />t raN A1_tjDAViT <br />fI illc':3 Lmted Status C.'udc Senium 112 and <br />I°ahlic Connect Code Section 79(16) <br />To the Cl TY Ol' 8M ]'A ANA DITARTMEN7 OF PUBLIC WORKS <br />In acenrdruce xuith I -Mc 23 Unbend 5tstcs Coale Swim 11, and Public Curengel Code 71W uhe BIDDER doelaas [ltd tlua'bid <br />is not numfc in Lae Interest OC, or on behalf of,, miy undue!asud pursm, padnurship, Company, assrnlaitlon, olgiol at.ime, ue <br />corporation; litre[ itte bid is gcnuinc arei rmt cnlbtsittV ur strum,; tint rho BIDDER has nM &1WIy nr indircUy- induced or <br />striated any other RiDD[ R to pan in A i Ne or shah Mail, and has not d'iwWly of indimty cgllutdoci, wnsphreA cuanive% ur <br />agresd ad,ith any BIDDERcm myon -&l to ,put hr aslutin bid, or that maydxne shell mfrain limn biddiq,t dims alhc BIDDFR hex <br />out in any manner, directly nr Indirecily, sauglit by agnx.mmi, iamrnuticatiost ur cum%rcYtce ac•ith anynne to Rx the bid price <br />of the BIDDER or any REDDER, or as rix tiny orrxr1lo0. pxoth, or cost eiemont of ibe bid prig, or of thea of fumy usher <br />BIDDER, or w secure any alsamage a gainit vhrc public bt;ly awardnti !hu i=nut of unysme hetero nml in the 1.hroposed <br />mmtmotp that ab eUilen'wnls auntamed lit oho (rid me I,= and, nufllm dhmt thrz BIDDER Yoa nM, dimcaly or iadi.Mlw, <br />,edlhminexi Iris or her hid prior; or arty breakdown tlteuenl m the content; tltewalr �or diuldiged inhnnition at villa eelmtdta <br />trims, or pail, and will nM pay, any fun w in) cotpurutwa lsunnenhip, carnpunp msquchaian, cogarn7alion, bid depositary, <br />or to any ntembor or nponi thenvEto etlecuuto a collu:uw'o or wham bid.. <br />Noly 'floe abu Moira: VnSinst ARodat'it Ss part ui' rho P,mnual Signingdus Prulomal on chc smmWe portion <br />dtcreuf shall a eansti Ia sign tunth x Nrnt callusiorr A.ffida, t. lel i'.a'DFR'w are cautioned Ibal making a iblsc <br />camifiminn r'airratrtal }rnise4`atlrun. <br />C,nwofnant Ne3Cc Kul <br />Staum oeCunfotniP' Larose Ceilltlsate <br />Count' of aftadled <br />Suk�.nr"bed and sworn to (or ill' nned) beim m- on chis day of _. , 211 , by' <br />pro%ed ranee on the Nn is ops d'IttmarY u4idntca to bathe 1.r' n(sf who apiximA beton torr. <br />blot➢;4' PnhI1C $I VIIAPLhIC '.'dfiftilY 1'ti hltl:'L .rs[!0I <br />City of Santa Ana RFP 15,047' <br />Page 22 <br />■u City of Santa ata <br />iii T TG 8ndge Preventive Maintenance Program - RFP#15-047 <br />