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CITY OF SANTA ANA <br />SPECIFICATIONS - PROPOSAL <br />PROJECT NO. 16-6849 <br />t;.IIT"YWIDE CONCRETE :IMPROVEMENT'S <br />PIIBLIK Ci 'NTRACT C"OI7 ? 5 ;;71ON 101 _�Li I'IONAIRE <br />In coxnformaance with Public Contract Code Section 10162, the BII1rDER shall complete, <br />under pcmalt r of perjury, the following questionnaire: <br />%las the BIDDER, any officer of the BIDDER, or any employee of the BIDDER who has a <br />proprrietrary interest in the BIDDER„ ever been disqualified, removed, or otherwise prevented <br />from bidding; on, or completing a federal, sir,nfe, or Local government project because of a <br />violation of law or a safetyregulation? <br />Yes __. No_ v __ <br />If the answer is yes, explain the circumstances in the following space. <br />Y <br />