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.4 . <br />City of Santa Ana <br />ITEM 14: CONFLICT OF INTEREST CERTIFICATION <br />The undersigned hereby certifies on behalf of <br />("Proposer"), and hereby declares under penalty of perjury under the laws of the State <br />of California, that Proposer is not, and will not be violating either directly or indirectly any <br />conflict of interest statute, rule, or regulation if awarded a contract and if authorized to <br />perform the services described in this RFP. <br />Signed, this day of 2018 in <br />California. <br />IF SOLE OWNER: <br />Signature of Owner <br />Print Name <br />IF PARTNERSHIP (JPA or mercer): <br />Signature of Partner (General Partner) <br />Print Name <br />IF CORPORATION: <br />Signature of President <br />Print Name <br />Signature of Secretary <br />Print <br />City of Santa Ana <br />Fire/EMS Emergency Ambulance Transportation and Related Services <br />Request for Proposals: # 18-059 <br />August 28, 2018 <br />250-123 <br />Date <br />Date <br />Date <br />Date <br />Page 187 <br />