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CITY OF SANTA ANA REBID <br />PROPOSAL <br />PROJECT NO.: 17-6611 <br />CHESTNUT AVE & BUSH /CYPRESS BIKE LANES <br />FAiD#: U58DPOO5861 <br />TITLE 49 CODE OF FEDERAL REGULATION. PART 29 DEBAR.hv FNT AND SUSPENSION <br />CERTIFICATION <br />The bidder under penalty of poiju y, certifies that except as noted below, he /she or any person <br />associated therewith in the capacity of owner, partner, director, officer, manager: <br />is not currently under suspension, debarment, voluntary exclusion, or determination of <br />ineligibility by any federal agency; <br />has not suspended, debarred, voluntarily excluded, or determined ineligible by any federal <br />agency within past three years; <br />has not been indicted, convicted, or had a civil judginent rendered against it by a court of <br />competent jurisdiction in any matter involving fraud or official misconduct within the past 3 <br />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 determining <br />bidders responsibility. For any exception noted above, indicate below to whom it applies, initialing <br />agency, and 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 <br />thereof shall also constitute signature of this Certification. <br />Signed <br />Title <br />Firn <br />Date 3A,117 <br />P -22 of P -39 <br />20B -32 <br />