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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 18-6916 <br />FLOWER ST. SLURRY: SUNFLOWER AVE. TO MACARTHUR BLVD. <br />PROJECT NO.: 18-6917 <br />MACARTHUR BLVD. SLURRY: RAITT ST. TO BRISTOL ST. <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA ) <br />COUNTY OF ORANGE ) SS: <br />CITY OF SANTA ANA /! A1�� �q�/t ) <br />RujoJ1� U. GWl ��Ydl I being duty sworn, deposes and says: <br />❑ INDIVIDUAL That he/she is the party making the foregoing proposal: <br />❑ PARTNERSHIP That he/she is a member of the co -partnership firm designated as: <br />and who has been and is duty 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 That he is of: <br />All American Asphalt the Vice President <br />a corporation which is making the foregoing proposal: <br />❑JOINT VENTURE 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 mating 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 contract, for himself P any other person. <br />Signature O'. Bidder fdward J. Carlson, Vice President <br />Subscribed and sworn to before me this day of 20 <br />*Please see attached California Jurat" <br />Signature of officer Administering Oath (Notary Public) <br />P-7 of P-17 <br />