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Project 13-6797 Maple Bike Trail Safety Enhancements At <br />Occidental Street, St. Andrew Place, and St. Gertrude Place; CM -5063(149) <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 <br />BIDDER hereby declares <br />under penalty of perjury under the laws of the State of California that the BIDDER has e , has not <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 <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 />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 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 <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 />C.P. CROWN, PEIESIDENI <br />Title R WIL FMr,a <br />LiAQ.V& V aA `+F T31 (10.,4 V °�;'1 Yf <br />Firm <br />Date <br />BP 24 of 26 <br />