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CITY OF SANTA ANA <br /> Project Nos. 04-6375, 04-7709 El Salvador Center Renovation <br /> Project No. 05-7806 El Salvador Park Improvements <br /> PROPOSAL AND CONTRACT AGREEMENT <br /> PUBLIC CONTRACT CODE SECTION 10285.1 STATEMENT <br /> In conformance with Public Contract Code Section 10285.1 (Chapter 376, Stats. 1985), the bidder <br /> hereby declares <br /> under penalty of perjury under the laws of the State of California that the bidder has_ , has not t✓ <br /> ve- <br /> been convicted <br /> within the preceding three years of any offenses referred to in that section, including any charge of fraud, <br /> bribery, collusion, conspiracy,or any other act in violation of any state or Federal antitrust law in <br /> connection with the bidding upon, award of, or performance of, any public works contract, as defined in <br /> Public Contract Code Section 1101, with any public entity, as defined in Public Contract Code Section <br /> 1100, including the Regents of the University of California or the Trustees of the California State <br /> University. The term "bidder" is understood to include any partner, member, officer, director, <br /> responsible managing officer, or responsible managing employee thereof, as referred to in Section <br /> 10285.1. <br /> Note: The bidder must place a check mark after"has" or"has not" in one of the blank spaces provided. <br /> The above Statement is part of the Proposal. Signing this Proposal on the signature portion <br /> thereof shall also constitute signature of this Statement. Bidders are cautioned that making a false <br /> certification may subject the certifier to criminal prosecution. <br /> Signed f = _ _ <br /> Title <br /> Firm ,Skr.,\-e s 1 1C Cer.vntsVMAX <br /> Date moi/3 <br /> TO BE INCLUDED IN BID PACKAGE <br /> BP 26 of 28 <br />