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~ ! <br />CITY OF SANTA ANA <br />Project No. 10-7554 Mid-City Neighborhood Improvement (west of Bristol St.) <br />Project No. 07-7577 Edinger Ave. Improvement from Mohawk St. to 400' e/o Mohawk St. <br />PROPOSAL AND CONTRACT AGREEMENT <br />PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT <br />In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the BIDDER <br />hereby declares <br />under penalty of perjury under the laws of the State of California that the BIDDER has _ ,has not _ <br />been convicted <br />within the preceding three years of any offenses referred to in that section, including any charge of <br />fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in <br />connection with the bidding upon, award of, or performance of, any public works contract, as defined in <br />Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section <br />1100, including the Regents of the University of California or the Trustees of the California State <br />• University. The term "BIDDER" is understood to include any partner, member, officer, director, <br />responsible managing officer, or responsible managing employee thereof, as referred to in Section <br />10285.1. <br />Note: The BIDDER must place a check mark after "has" or "has not" in one of the blank spaces <br />provided. The above Statement is part of the Proposal. Signing this Proposal on the signature <br />portion thereof shall also constitute signature of this Statement. BIDDERS are cautioned that <br />making a false certification may subject the certifier to criminal prosecution. <br />Signed <br /> <br />Title r <br />~~ ~~ ~ ~ 'U( C6 I~~SI ~ <br />Firm l ~' ~ ~l ~-~-C-J~-~ ~ ~ 6~74-C~~' <br />Date ~'~) _ ~ ! Z~ ( O <br />• <br />TO BE INCLUDED IN BID PACKAGE <br />BP 29 of 31 <br />