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CITY OF SANTA ANA <br />PROPOSAL <br />PROD EC T NO.: 16-6371 <br />SAFE ROUTES TO SCHOOL ENPIACEMENTS FOR ICING ELEMENTARY <br />STATE PROJECT NO: ATFL- 5063(160) <br />NON -COLLUSION AFFIDAVIT <br />(Title 23 United States Code Section 1 12 and Public Contract Code Section 7106) <br />in conformance with Title 23 United States Code Section 112 and Public Contract Code 7106 the <br />BIDDER declares that the bid is not inade in the interest oC or on behalf of. any undisclosed <br />person, partnership, company, association, organization, or corporation; that the bid is genuine <br />and not collusive or share; 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 put in a sham bid, or that <br />anyone shall refrain from bidding; that the BIDDER has not in any manner, directly of indirectly, <br />sought by agreement, communication, or conference with anyone to fix the bid price of the <br />BIDDER or any other BIDDER, or to fix any overhead, profit, or cost element of tike bid price, <br />or of that of 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 bid 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 part of the Proposal. BIDDERS are <br />cautioned that makina false certification may subject the certifier to criminal <br />7 <br />prosecution. � r ---_._,n <br />Signed <br />State of California <br />County of _ jQs Angeles <br />Subscribed and sworn to (or affirmed) before me on this <br />proved to ane oil the basis <br />person(s) who appeared before tile <br />Notary Public Signature <br />day oi' 20, by <br />of satisfactory evidence to be the <br />Notary Public Seal <br />P-12 of P- 17 <br />23A-40 <br />