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23A - PROJ - 3RD ST PAVING
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05/17/2016
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23A - PROJ - 3RD ST PAVING
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Last modified
5/12/2016 11:34:28 AM
Creation date
5/13/2016 8:51:11 AM
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
5/17/2016
Destruction Year
2021
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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO. 15 -6606: 3RD STREET TRAFFIC CALMING (FAID# U58DP005861) <br />PUBLIC CONTRACT CODE SECTION 10162 QUESTIONNAIRE <br />In conformance with :Public Contract Code Section 10162, the BIDDER shall complete, <br />under 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 <br />If the answer is yes, explain the circumstances in the following space. <br />
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