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• CITY OF SANTA ANA <br />PROJECT N0.08-5018: TRAFFIC SIGNAL INSTALLATION ON HAZARD AVE & ROSITA ST <br />PROJECT N0.08-5019: TRAFFIC SIGNAL INSTALLATION ON HAZARD AVE E/O GATES ST <br />PROJECT NO. 08-5020: TRAFFIC SIGNAL MODIFICATION ON MCFADDEN AV & NEWHOPE AV <br />PROPOSAL AND CONTRACT AGREEMENT <br />TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 <br />DEBARMENT AND SUSPENSION 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 ineligibility by <br />any federal agency; <br />has not suspended, debarred, voluntarily excluded, or determined ineligible by any federal agency within <br />past three years; <br />has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent <br />jurisdiction in any matter involving fraud or official misconduct within the past 3 years. <br />If there are any exceptions to this certification, insert the exceptions in the following space. <br />• <br />Exceptions will not necessarily result in denial of award, but will be considered in determining bidders <br />responsibility. For any exception noted above, indicate below to whom it applies, initialing agency, and dates of <br />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 thereof shall also <br />constitute signature of this Certification. <br />Name of F <br />Signature of Bidder <br />FED.8-22-88 <br />• <br />TO BE INCLUDED IN BID PACKAGE <br />BP 18 of 32 <br />