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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 18-6918 <br />MAIN ST & 15TH ST TRAFFIC SIGNAL INSTALLATION <br />FEDERAL PROJECT NO: HSIPL 5063 (189) <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 fraud 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 certification is part of the Proposal. Signing this Proposal on the signature portion <br />thereof shall also constitute signature of this Certification. <br />Signed X4 1 �- u1....- <br />Title vice <br />Firm Elecnor Belco Electric, Inc. <br />Date 11/8/2021 <br />P-34 of P-52 <br />