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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 19-6943 <br />BRISTOL ST. REHABILITATION: MACARTHUR BLVD. TO RAILROAD (N. OF <br />ALTON AVE.) <br />STATEMENT REGARDING "ANTI -KICKBACK" REQUIREMENTS <br />The undersigned is submitting this proposal for performing by contract the work required by these <br />bid documents, agrees to comply with the Copeland "Anti -Kickback" Act (18 USC 74) as <br />supplemented in the Department of Labor regulations (29 CFR, Part 3). This act provides that <br />each contractor or subcontractor shall be prohibited from inducing, by any means, any person <br />employed in the construction or repair of public work, to give up any part of the compensation to <br />which he/she is otherwise entitled. <br />Signed: <br />Title: <br />Edward J. Carlson, Vice President <br />Firm: <br />All Asphalt <br />Date: <br />{American <br />1 Q�117(201 j <br />21d_' <br />