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20D - AA FOR TRAFFIC SIGNAL MODIFICATION
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20D - AA FOR TRAFFIC SIGNAL MODIFICATION
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Last modified
5/14/2020 4:22:38 PM
Creation date
5/14/2020 4:15:11 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
20D
Date
5/19/2020
Destruction Year
2025
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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 17-6894 <br />EUCLID STREET AT HAZARD AVENUE SIGNAL MODIFICATION <br />FEDERAL PROJECT NO: HSIPL 5063 (171) <br />TITLE 49, CODE OF FEDERAL REGULATION, PART 29 DEBARMENT AND SUSPENSION <br />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 <br />ineligibility by any federal agency; <br />has not suspended, debarred, voluntarily excluded, or determined ineligible by any federal <br />agency within past three years; <br />has not been indicted, convicted, or had a civil judgment rendered against it by a court of <br />competent jurisdiction in any matter involving fiaud or official misconduct within the past 3 <br />years. <br />If there are any exceptions to this certification, insert the exceptions in the following space. <br />Exceptions will not necessarily result in denial of award, but will be considered in determining <br />bidder's responsibility. For any exception noted above, indicate below to whom it applies, initialing <br />agency, and dates of action. <br />Note: Providing false information may result in criminal prosecution or administrative sanctions. <br />The above certificati is part of a Proposal. Signing this Proposal on the signature portion thereof <br />shall also constitut. signature o s Certification. <br />Signed <br />Title Earnest Brown- President So Cal Div. <br />Firm International Line Builder's, Inc. <br />Date 02/26/2020 <br />
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