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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NOS.: 16-6864 AND 18-6864 <br />OMNIBUS CONCRETE REPAIR PROJECT <br />PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE <br />In conformance with Public Contract Code Section 10162, the BIDDER shall complete, <br />under penalty of perjury, 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 <br />from bidding on, or completing a federal, state, or local government project because of a <br />violation of law or a safety regulation? <br />Yes No V <br />If the answer is yes, explain the circumstances in the following space. <br />P-21 of P-21 <br />