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CITY OF SANTA ANA <br />Project No. 08-1732: Grand Avenue Widening from First Street to Fourth Street <br />Project No. 12-6604: Grand Avenue Storm Drain from First Street to Fourth Street <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 under penalty of perjury under the laws of the State of California that the BIDDER <br />has® , has not__V/been convicted within the preceding three years of any offenses referred to in that <br />section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any <br />state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any <br />public works contract, as defined in Public Contract Code Section 1101, with any public entity, as <br />defined in Public Contract Code Section 1100, including the Regents of the University of California or <br />the Trustees of the California State University. The term 'BIDDER" is understood to include any <br />partner, member, officer, director, responsible managing officer, or responsible managing employe, <br />thereof, as referred to in Section 10285.1. <br />Note: The BIDDER must place a check marls 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 constitute signature of this Statement. BIDDERS are cautioned that <br />making a false certification may subject the certifier to criminal prosecution. <br />Signed <br />Title <br />EALP INS. <br />Firm ��tK".twp m,mmr Pam <br />Date t+lll`, ` - ,1 7014 <br />TO BE INCLUDED IN BID PACKAGE <br />BP 29 of 31 <br />