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CITY OF SANTA ANA <br />PROJECT NO. 12 -6758: TRAFFIC SIGNAL INSTALLATION ON FAIRVIEW ST & EDNA DR <br />PROJECT NO. 12 -6759: TRAFFIC SIGNAL MODIFICATION ON MCFADDEN AVE & EUCLID 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 hereby <br />declares <br />under penalty of perjury under the laws of the State of California that the BIDDER has _ , has not4 <br />been convicted <br />within the preceding three years of any offenses referred to in that section, including any charge of fraud, <br />bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection <br />with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract <br />Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the <br />Regents of the University of California or the Trustees of the California State University. The term <br />"BIDDER" is understood to include any partner, member, officer, director, responsible managing officer, or <br />responsible managing employee thereof, as referred to in Section 10285.1. <br />Note: The BIDDER must place a check mark after "has" or "has not" in one of the blank spaces provided. <br />The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof <br />shall also constitute signature of this Statement. BIDDERS are cautioned that making a false <br />certification may subject the certifier to criminal prosecution. <br />Date t 1 <br />TO BE INCLUDED IN BID PACKAGE <br />BP 28 of 30 <br />