Laserfiche WebLink
CITY OF SANTA ANA <br />PROPOSAL AND CONTRACT AGREEMENT <br />PROJECT 12-7527, 12-7528, 12-7529, 12-7530 <br />TI"I'LE 49, CODE OF FEDERAL REGULATIONS, PART 29 <br />DEBARMENT AND SUSPENSION CERTIFICATION <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 ineligibility <br />by any federal agency; <br />leas not suspended, debarred, voluntarily excluded, or determined ineligible by any federal agency <br />within past three years; <br />has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent <br />jurisdiction in any matter involving fraud or ofllcial misconduct within the past 3 years. <br />If there are any exceptions to this certification, insert the exceptions in the following space <br />C v_ <br />Exceptions will not necessarily result in denial of award, but will be considered in determining <br />BIDDERS responsibility. For any exception noted above, indicate below to whom it applies, initialing <br />agency, and dates of action. `, <br />C? <br />Note: Providing false information may result in criminal prosecution or administrative sanctions. <br />The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall <br />also constitute signature of this Certification. <br />?S,I?R a?4'G.I? <br />Name of BIDDE???`" ?????? ?????? <br />Signature of BIDDER <br />FED.8-22-88 Date??tni ? oo,? ? _ F . BROW t?F <br />?.r?r - qtr- P R E S I !7 E. a <br />TO BE TNCLUDED IN BID PACKAGE <br />BP 21 of 37