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CITY OF SA NTA ANA <br />PROPOSAL <br />PROJECT NO.: 14-6802 WARNER AVENUE STREET IMPROVEMENTS (MAIN TO OAK) <br />PROJECT NO.: 18-6424 WARNER AVENUE WATER MAIN IMPROVEMENTS (MAIN TO OAK) <br />PROJECT NO.: 20-6618 WARNER AVE STORM DRAIN IMPROVEMENTS (MAIN TO QAK) <br />PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE <br />In conformance with Public Contract Code Section 10162, the BIDDER shall complete, <br />under penalty otperiury, the following questionnaire: <br />Has the BIDDER, any officer of the BIDDER, or any employee of the BIDDER who has a <br />proprietary interest in the BIDDER, ever been disqualified, removed, or otherwise prevented from <br />Bidding on, or completing a federal, state, or local government project because of a violation of <br />law or a safety regulation? <br />Yes No t/ <br />Ifthe answer is yes, explain the circumstances in the following space. <br />P-22 of P-23 <br />