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CITY OF SANTA ANA <br />PROPOSAL AND CONTRACT AGREEMENT <br />Project 13 -6797 Maple Bike Trail Safety Enhancements At <br />Occidental Street, St. Andrew Place, and St. Gertrude Place; CM- 5063(149) <br />TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 <br />DEBARMENT AND SUSPENSION CERTIFICATION <br />The BIDDER under penalty of perjury, certifies that except as noted below, he /she or any person <br />associated therewith in the capacity of owner, partner, director, officer, manager: <br />is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility <br />by any federal agency; <br />has not suspended, debarred, voluntarily excluded, or determ red ineligible by any federal agency <br />within past three years; <br />has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent <br />jurisdiction in any matter involving fraud or official misconduct within the past 3 years. <br />If there are any exceptions to 0* <br />Exceptions imcrt the exceptions in the following space. <br />1 V` <br />Exceptions will not necessarily result in denial of award, but will be considered in determining <br />BIDDERS responsibility. For any exception noted above, indicate below to whom it applies, initialing <br />agency, and dates of action. <br />Note: Providing false information may result in criminal prosecution or administrative sanctions. <br />The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall <br />also constitute signature of this Certification. RALP s ., _ <br />COM PAs�P <br />Name of BIDDER <br />Signature of BIDDER <br />G.P. 1ow k <br />Date <br />FED.8 -22 -88 S PREsWENT <br />BP 17 of 26 TO BE INCLUDED IN BID PACKAGE <br />23BB -27 <br />