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CIZ'~' Off' SAi~l~a'A 1~ ILIA. <br /> PROJECT NO. 05-3195 <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. 1955), the bidder <br /> hereby declares <br /> under penalty of perjury under the laws of the State of California that the bidder has ~ ,has not <br /> .X been convicted <br /> within the preceding three years of any offenses referred to in that section, including any charge of <br /> fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust <br /> law in connection with the bidding upon, award of, or performance of, any public works contract, as <br /> defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract <br /> Code Section 1100, including the Regents of the University of California or the Trustees of the <br /> i California State University. The term "bidder" is understood to include any partner, member; <br /> officer, director, responsible managing officer, or responsible managing employee thereof, as <br /> referred to in Section 102°05.1. <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 prosecution. <br /> Signed: <br /> Title: R.P. ZIEBARTH, PRESIDENT <br /> F.T. ZIEBARTH COMPANY <br /> Firm: <br /> Date: 04/22/10 <br /> TO BE INCLUDED IN BID PACKAGE <br /> BP23o#'26 <br /> <br /> L <br /> <br />