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CITY OF SANTA ANA PROPOSAL PROJECT NO. 15-6830: Pedestrian Countdown Heads and Push Buttons PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder hereby declares under penalty of perjury under the laws of the State of California that the bidder has _, has not X been convicted within the preceding three years of any offenses referred to in that section, including any charge of fraud, bribery, collusion, conspiracy, or any other act in violation of any state or Federal antitrust law in connection with the bidding upon, award of, or performance of, any public works contract, as defined in Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section 1100, including the Regents of the University of California or the Trustees of the California State University. The term "bidder" is understood to include any partner, member, officer, director, responsible managing officer, or responsible managing employee thereof, as referred to in Section 10285.1, Note: The bidder must place a check mark after "has" or "has not" in one of the blank spaces provided. The above Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false certification may subject the certifier to criminal prosecution. Signed Title ' ) k -cc -A -Dc- Q-• Eaac, n -e- Firm SIEMENS INDUSTRY INC Date ****At present Siemens ITS business unit, of Siemens Industry, Inc. has no pending criminal, civil or administrative litigations. Please note that this certification primarily reflects information related only to the ITS Mobility business unit and not to its affiliates. ITS is a part of a large corporate enterprise, with numerous directly or indirectly controlled or controlling affiliates, conducting various disparate businesses in multiple jurisdictions, and employing over 60,000 employees in the United States. Information from Siemens Industry, Inc. affiliates regarding issues not material to the business of Siemens Industry, Inc. is generally not centrally maintained by Siemens Industry, Inc. SII performs tens of thousands of projects annually through over one hundred offices. As such SII has been involved in miscellaneous litigations and disputes arising out of its business none of which are of a material nature as to adversely impact its ability to completely and satisfactorily perform any of its projects. As a result, Siemens Industry, Inc. cannot ensure the completeness of such information. Consequently a material risk of insolvency to either the Service Provider or Guarantor or materially affect the Service Provider's or Guarantor's ability to perform their obligations due to pending litigation is not apparent.*** BP -19