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CITY O. SANTA ANA: <br />PROJECT <br />PROPOSAL SA <br />(ADDENDUM IF 20 16) <br />(Title 23 United States Code Section 112 and <br />Public Contract Cade Section 7106) <br />In accordance with Title 23 United 'States Code Section 112 and Public Contract Grade <br />7106 the BIDDER declares that the bid is not made in the interest of, or on behalf of, <br />any undisclosed person, partnership, company, association, organization, or <br />corporation; that the bid is genuine and not collusive or sham; that the BIDDER has not <br />directly or indirectly Induced or solicited any other BIDDER to plat in a false or sham bid, <br />and has not directly or indirectly colluded, conspired, connived or agreed with any <br />BIDDER or anyone else to put in a sham bid, or that anyone shall refrain from bidding; <br />that the BIDDER has not in any manner, directly or indirectly„ sought by agreement, <br />communication, or conference with anyone to fix the bid price of the BIDDEN or any <br />BIDDER, or to fix any overhead, profit„ or coast element of the bid price, or of that of any <br />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 <br />the bid are true; and, further, that the BIDDER has not, directly or indirectly, submitted <br />his or her bid price or any breakdown thereof, or the contents thereof, or divulged <br />information or data relative thereto, or paid, and will not pay, any fee to any corporation, . <br />partnership, company association, organization, bid depository, or to any member or <br />agent thereof to effectuate a collusive or sham bid, <br />Note: The above Non- coltusion Affidavit is part of the Proposal'. Signing this <br />Proposal on the signature portion thereof shall also constitute signature of this <br />Pion- collusion Affidavit, BIDDERS are cautioned that making a false certification <br />may slabject;thp certifier to criminal prosecution. <br />Signed1 saki, i. <br />State of California <br />County of <br />Subscribed and sworn to (or affirmed) before me on this __ day of s,n, 20­, <br />by �, proved to me on the basis of satisfactory evidence to <br />be the person(s) who appeared before me <br />Notary Public Signature Notary Public Seal <br />1 1,1 Hn G J(..Yy'yd fapl �r01, ^t, , Hr.[il (:h t r: Pt,t«?�' 7 'il ifi. <br />23A -28 <br />