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CITY OF SANTA ANA <br />PROJECT NOS. 12 -6753, 12 -7531, & 1 ] -2618 <br />PROPOSAL AND CONTRACT AGREEMENT <br />PUBLIC CONTRACT CODE SECTION 10162 OUESTIONAIRE <br />In conformance with Public Contract Code Section 10162, the BIDDER shall complete, under penalty of <br />perjury, the following questionnaire: <br />Has the BIDDER, any officer of the BIDDER, or any employee of the BIDDER who has a proprietary <br />interest in the BIDDER, ever been disqualified, removed, or otherwise prevented from bidding on, or <br />completing a federal, state, or local government project because of a violation of law or a safety <br />regulation? <br />Yes No X <br />If the answer is yes, explain the circumstances in the following space. <br />N/A <br />TO BE INCLUDED IN BID PACKAGE <br />BP 30 of 31 <br />