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EXHIBIT 1 <br />CITY OF SANTA ANA <br />REQUEST FOR PROPOSALS FOR <br />SECURE BIKE PARKING FACILITIES <br />Installation and Service Agreement <br />RFP #13.919 <br />TITLE 49, CODE OF FEDERAL REGULATIONS, PART 29 <br />DEBARMENT AND SUSPENSION CERTIFICATION <br />The BIDDER under penalty of perjury certifies that except as noted below, he/she or any person associated <br />therewith in the capacity of owner, partner, director, officer, manager: <br />Is not currently under suspension, debarment, voluntary exclusion, or determination of ineligibility by any <br />federal agency; <br />Has not suspended, debarred, voluntarily exclttded, or determined ineligible by any federal agency within <br />past three years; <br />has not been indicted, convicted, or had a civil judgment rendered against it by a court of competent <br />jurisdiction in any matter involving fraud or official misconduct within the past 3 years. <br />If there are any exceptions to this certification, insert the exceptions in the following space <br />Exceptions will not necessarily result in denial of award, but will be considered in detennining BIDDERS <br />responsibility. For any exception noted above, indicate below to whom it applies, initialing agency, and <br />dates of action. <br />Note: Providing false information may result in criminal prosecution or administrative sanctions. <br />The above certification is part of the Proposal. Signing this Proposal on the signature portion thereof shall <br />also constitute signature of this Certification. <br />Name of BID ER <br />Signs o ER <br />Date S 1 13 <br />THIS FORM MUST BE COMPLETED AND JNCLUDED WITH THE PROPOSAL. <br />PROPOSALS THAT 00 NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. <br />- <br />CRy of Santa Ana RFP 13-019 <br />Page 28 <br />25A -51 <br />