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CITE' OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 15-6843 <br />SAFE TRANSIT STOPS <br />NON -COLLUSION AEEIDAM <br />(Title 23 United States Code Section 112 and <br />Public Contract Code Section 7106) <br />ht 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 <br />person, partnership, company, association, organization, or corporation; that the bid is genuine <br />and not collusive or sham; that the BIDDER has not directly or indirectly induced or solicited <br />any other BIDDER to put in a false or sham bid, and has not directly or indirectly colluded, <br />conspired, connived or agreed with any BIDDER or anyone else to taut in a sham bid, or that <br />anyone shall refrain from bidding; that the BIDDER, has not in any manner, directly or indirectly, <br />sought by agreement, communication, or conference with anyone to fix the bid. price of the <br />BIDDER or any BIDDER, or to fix any overhead, profit, or cost element of the bid price, or of <br />that or any other BIDDER, 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 bid are <br />true; and, further, that the BIDDER has not, directly or indirectly, submitted his or her bird price <br />or any breakdown thereof, or the contents thereof, or divulged information or data relative <br />thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, <br />organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham <br />bid. <br />Note: The above Non -collusion Affidavit is <br />on the signature portion thereof shall also <br />Affidavit. BIDDERS are cautioned that in <br />certifier to criminal prosecution. y <br />Signed. <br />State of California <br />County of ORANGE <br />Subscribed and sword to (or affiinned) before <br />Michael Martin , proved to me on <br />person(s) who appeared b fore me <br />Notary Public Signature <br />part of the Proposal. Signing this Proposal <br />constitute signature of this Non -collusion <br />may subject the <br />me on this 25th day of April , 20 i G by <br />the basis of satisfactory evidence to be the <br />NICK MARTIN <br />Commission # 1918731 <br />Notary Public -California z <br />_ Orange County <br />M Camm. Expires Mag 27,2016 <br />Notary Public Seal <br />P-11 of P-16 <br />