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CITY OF SANTA ANA <br />PROJECT N0.08-5018: TRAFFIC SIGNAL INSTALLATION ON HAZARD AVE & ROSITA ST <br />PROJECT NO.OS-5019: TRAFFIC SIGNAL INSTALLATION ON HAZARD AVE E/O GATES ST <br />• PROJECT NO. 08-5020: TRAFFICSIGNAL MODIFICATION ON MCFADDEN AV & NEWHOPE AV <br />PROPOSAL AND CONTRACT AGREEMENT <br />PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT <br />In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby <br />declares under penalty of perjury under the laws of the State of California that the bidder has _ , <br />has not 'been convicted within the preceding three years of any offenses referred to in that section, <br />including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or <br />Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works <br />contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public <br />Contract Code Section 1100, including the Regents of the University of California or the Trustees of the <br />California State University. The term "bidder" is understood to include any partner, member, officer, <br />director, responsible managing officer, or responsible managing employee thereof, as referred to in Section <br />10285.1. <br />Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The <br />• above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall <br />also constitute signature of this Statement. Bidd s are cautioned that making a false certification may <br />subject the certifier to crim' pro <br />Signed <br />Title <br />Firm <br />President <br />Date ~~ ~~ I ~ ~ <br />• <br />TO BE INCLUDED IN BID PACKAGE <br />BP 30 of 32 <br />