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23A - PROJ - DELHI CHANNEL PROJECT
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23A - PROJ - DELHI CHANNEL PROJECT
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Last modified
12/1/2016 4:04:21 PM
Creation date
12/1/2016 3:51:56 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
12/6/2016
Destruction Year
2021
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CITY OF <br />PROJECT� NO. 16-6467 <br />9A- 1=yl♦1LQTAJFrT <br />PROPOSAL <br />(ADDENDUM ONE — JULY 22, 2016) <br />,TUBI,, C0N'�'R I'LONI01Irl �3t11.5"I'ION? AIRF, <br />In conformance with Public Contract Code Section 90162, the BIDDER shall <br />complete, under penalty of perjury, the following questionnaire <br />Has the BIDDER, any officer of the BIDDER, or any employee of the BIDDER who has <br />a proprietary interest in the BIDDER, ever been disqualified, removed, or otherwise <br />prevented from bidding on, or completing a federal, state, or local government project <br />because of a violation of law or a safety regulation? <br />Yes No <br />If the answer is yes, explain the circumstances in the following space. <br />i.ir� s5t <br />Sranlrz F,n.1 f rsre+�,� <br />a 1fiP,•4r" .:.=o];i For H�rjl7.��'i 0�4�y r7t �r� Iliv��n i ,i ! <br />'lac; <br />('t'¢4dl) � 7i.'.nh,r r .'1116 <br />23A-34 <br />
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