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CITY OF SANTA ANA RE -BID <br />PROPOSAL <br />PROJECT NO.: 17-6876 <br />CROSSWALK UPGRADES PHASE II <br />FEDERAL PROJECT NO: HSIPL 5063(186) <br />PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT <br />In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the <br />bidder hereby declares under penalty of perjury under the laws of the State of California that the <br />bidder has _ , has not X been convicted within the preceding three years of any offenses <br />referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any <br />other act in violation of any state or Federal antitrust law in connection with the bidding upon, <br />award of, or performance of, any public works contract, as defined in Public Contract Code <br />Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including <br />the Regents of the University of California or the Trustees of the California State University. <br />The term "bidder" is understood to include any partner, member, officer, director, responsible <br />managing officer, or 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 <br />provided. The above Statement is part of the Proposal. Signing this Proposal on the <br />signature portion thereof shall also constitute signature of this Statement. Bidders are <br />cautioned that making a false certification may subject the certifier to criminal <br />prosecution. <br />Signed <br />Title <br />Firm `Elecnorl3ett o Electric. Inc. <br />Date <br />John <br />i� �pf P. 4 RE -BID <br />