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Note: This form is to be notarized by a Notary Public. <br />Non -Collusion Affidavit <br />(Public Contract Code Section 7106) <br />Non -collusion Affidavit to be Executed <br />by Bidder and Submitted with Bid <br />Lincoln Elementary School — Cafeteria Replacement <br />Manteca Unified School District <br />State of California ) <br />} ss. <br />County of ) <br />it , being first duly sworn, deposes and says that he <br />or she is of f the <br />party making the foregoing bid 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 and not <br />collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a <br />false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or <br />anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any <br />manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid <br />price of the bidder 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 true; and <br />further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or <br />the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any depository, <br />or to any member or agent thereof to effectuate a collusive or sham bid." <br />State of <br />County of <br />On <br />Date <br />Company Name <br />Company Address <br />Signature of Officer <br />Title <br />before me, <br />Name and Title of Officer (e.g., "Jane Doe, Notary Public") <br />personally appeared , personally <br />Name(s) of Signer(s) <br />known to me - OR - proved to me on the basis of satisfactory evidence to be the person (s) whose name(s) <br />is/are subscribed to the within instrument and <br />acknowledged to me that he/she /they executed the <br />same in his/her/their authorized capacity(ies), and that <br />by his/her/their signature(s) on the instrument the <br />person(s), or the entity upon behalf of which the <br />person(s) acted, executed the instrument. <br />WITNESS my hand and official seal. <br />Signature of Notary Public <br />1:11207 lincoln as - cafeteria replacement14.06 projmanlnon-cols.doc <br />