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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 16-6859 <br />LOCAL STREET SLURRY SEAL 2015-16 <br />STATEMENT REGARDING "ANTI -KICKBACK" REQUIREMENTS <br />The undersigned is submitting this proposal for performing by contract the work required by <br />these bid documents, agrees to comply with the Copeland "Anti -Kickback" Act (18 USC 74) as <br />supplemented in the Department of Labor regulations (29 CFR, Part 3). This act provides that <br />each contractor or subcontractor shall be prohibited from inducing, by any means, any person <br />employed in the construction or repair of public work, to give up any part of the compensation to <br />which he/she is otherwise entitled. <br />Signed: L�.,�,.Pi+ /4 '/�i^---- <br />Title: cl b <br />Firm: TET/Z uA m 9AjzFg4&s SNNod A?7on/, LLL <br />Date: (0-/0 <br />P-15 of P-16 <br />