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' City of Santa Ana <br />ITEM 14: CONFLICT OF INTEREST CERTIFICATION <br />The undersigned hereby certifies on behalf of ("Proposer"), <br />and hereby declares under penalty of perjury under the laws of the State of California, <br />that Proposer is not, and will not be violating either directly or indirectly any conflict of <br />interest statute, rule, or regulation if awarded a contract and if authorized to perform the <br />services described in this RFP. <br />Signed, this day of 2018 in <br />California. <br />IF SOLE OWNER: <br />Signature of Owner <br />Print Name 1. <br />IF PARTNERSHIP (JPA or merger): <br />Signature of Partner (General Partner) <br />Date <br />Date <br />Print Name - <br />IF CORPORATION: <br />Signature of President Date <br />Print Name <br />Signature of Secretary Date <br />Print Name <br />City of Santa Ana Page 186 <br />Fire/EMS Emergency Ambulance Transportation and Related Services <br />Request for Proposals: # 18-059 <br />August 28, 2018 <br />flp mI: <br />