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CITY OF SANTA ANA PROPOSAL PROJECT NO. 15-6830: Pedestrian Countdown Heads and Push Buttons TITLE 49 CODE OF FEDERAL REGULATIONS PART 29 DEBARMENT AND SUSPENSION CERTIFICATION The bidder under penalty of perjury, certifies that except as noted below, he/she or any person associated therewith in the capacity of owner, partner, director, officer, manager: is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any federal agency; has not suspended, debarred, voluntarily excluded, or determined ineligible by any federal agency within past three years; has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent jurisdiction in any matter involving fraud or official misconduct within the past 3 years. If there are any exceptions to this certification, insert the exceptions in the following space. Exceptions will not necessarily result in denial of award, but will be considered in determining bidders responsibility. For any exception noted above, indicate below to whom it applies, initialing agency, and dates of action. Note: Providing false information may result in criminal prosecution or administrative sanctions. The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Certification. Name of Bidder SIEMENS INDUSTRY INC Signature of Bidd 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, file, is generally not centrally maintained by Siemens Industry, Inc. SII performs tens of thousands of projects annually through over one hundred offices. As such SIl 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 -21