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CITY OF SANTA ANA <br />PROJECT 12-2620, RPSTPLE 5063 (143) — FLOWER STREET BIKE TRAIL GAP CLOSURE <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 <br />hereby declares / <br />under penalty of perjury under the laws of the State of California that the BIDDER has ®, has not V <br />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 law in <br />connection with the bidding upon, award of, or performance of, any public works contract, as defined in <br />Public Contract Code Section 1.1.01, with any public entity, as defined in Public Contract Code Section <br />I 100, including the Regents of the University of California or the Trustees of the California State <br />University. The term "BIDDER" is understood to include any partner, member, officer, director, <br />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 <br />provided. The above Statement is part of the Proposal. Signing this Proposal on the signature <br />portion thereof shall also constite signature of this Statement. BIDDERS are cautioned that <br />�—� a false certification may ubject the certifier to criminal prosecution. <br />Title <br />Firm Green Giant Landscape, Inc. <br />Date "ne, '2 7. -M13 <br />TO BE INCLUDED IN BID PACKAGE <br />BP 27 of 29 <br />