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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO. 15-6836: RESIDENTIAL STREET REPAIR FY 14/15 <br />PROJECT 15-6452; WILSHIRE AVE. AND BORCHARD AVE. WATER MAIN IMPROVEMENTS <br />PUBLIC CONTRACT CODE SECTION 10162 QUEST10NAIRE <br />In conformance with Public Contract Code Section 10162, the BIDDER shall complete, under <br />penalty of perjury, the following questionnaire: <br />Has the BIDDER, any officer of the BIDDER, or any employee of the BIDDER who has a <br />proprietary interest in the BIDDER, ever been disqualified, removed, or otherwise prevented <br />from bidding on, or completing a federal, state, or local government project because of a <br />violation of law or a safety regulation? <br />Yes No v <br />If the answer is yes, explain the circumstances in the following space. <br />BP -17 of 17 <br />23A-34 <br />