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CITY OF SANTA, ANA <br />PIZOPOSAL <br />PROJECT NO.; I8-6006 <br />EDINGER AVE. AND BRISTOL ST. CLASS Il BICYCLE LANES <br />FEDERAL PROJECT NO: HSIPL $063(190) <br />The bidder under penalty of perjury, certifies that except as noted below, he/she or any person <br />associated therewith in the capacity of owner, partner, director, officer, manager; <br />is not currently under suspension, debarment, voluntary exclusion, or determination of <br />ineligibility by any federal agency; <br />has not suspended, debarred, voluntarily excluded, or determined ineligible by any federal <br />agency within past three years; <br />has not been indicted, convicted, or had a civil judgment rendered against it by a court of <br />competent jurisdiction in any matter involving fraud or official misconductWithin the past 3 <br />years. <br />If there are any exceptions to, this.certificatlon, Insert tile exceptions In the following space. <br />Exceptions will not necessarily result in :denial of award, but will be considered 'in determining <br />bidder's responsibility. For any exception noted above, indicate below to whom it applies, initialing <br />agency, and dates ofaction, <br />Note: Providing raise inforniatitrn May result In criminal prosecution or administrative sanctions. <br />'rho above certification is part of the Proposal. Sighing this Proposal on the signature portion thereof <br />shall also constitute signature of this Certification. <br />Signed <br />Title Edward J, Carlson, Vice President <br />Finn All American Asphalt _. <br />Date <br />P-22 of P-40 <br />