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Last modified
7/31/2019 8:54:30 AM
Creation date
6/27/2018 3:53:38 PM
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Contracts
Company Name
BELCO ELECTRIC, INC.
Contract #
17-6893
Agency
Public Works
Council Approval Date
4/3/2018
Document Relationships
23A - TRAFFIC SIGNAL MODIFICATION
(Attachment)
Path:
\Agenda Packets / Staff Reports\City Council (2004 - Present)\2018\04/03/2018
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OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA <br />) <br />COUNTY OF ORANGE <br />)SS: <br />CITY OF SANTA ANA <br />) <br />John Wong <br />being duly sworn, deposes and says: <br />❑ INDIVIDUAL <br />That he/she is the party making the foregoing proposal: <br />❑ PARTNERSHIP <br />That he/she is a member of the co -partnership firm designated as: <br />and who has been and is duly vested with the authority to make and execute instruments <br />for the co -partnership by: <br />who constitute the other members of the co -partnership. <br />® CORPORATION <br />That he is of: <br />a corporation which is making the foregoing proposal: <br />❑ JOINT VENTURE <br />That he is of: <br />one of the parties making the foregoing proposal as ajoint venture, and the he/she has <br />been and is duly vested with the authority to execute instruments for an on behalf of the <br />parties making said bid who are: <br />that such a bid is genuine and not collusive or sham, and has not in any manner sought by <br />collusion to secure any advantage against the City of Santa Ana or any person interested in the <br />proposed c9gtract, for himself or any other person. <br />of <br />before me this day of ( I 1 �1 20 AU <br />Oath (Notary Public) <br />^•"^••�••�»••»- <br />":.: s;.. <br />OLIVIA CHEA <br />A notary public or other officer completing <br />this certificate verifies only the identity of <br />" o <br />i �L„ <br />Commission No. 2107474 z <br />NOTARY <br />the individual who signed the document to <br />which this certificate is attached, and not <br />the truthfulness, accuracy, or validity of <br />,f <br />PUBLIC-CALIFORNIA U <br />fE'° <br />SAN BERNARDINO COUNTY <br />that document. <br />My Comm. Expires APRIL 18, 2019 <br />REBID Project 17-6893 - December 20, 2017 <br />
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