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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO,: 16.6862 <br />CABRILLO PARK SIDEWALK IMPROVEMENTS <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA ) <br />COUNTY OF ORANGE ) SS: <br />CITY OF SANTA ANA ) <br />...�"...� �:' C.RR +"�✓td L..e7 , being duly sworn, deposes and says <br />DINDIVIDUAL Thal he/she is the party maldng the foregoing proposal: <br />❑ PARTNERSHIP That he/she is a member of the oo•partnership Hmt designated as: <br />and who has been and N 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-patlnership. <br />,CORPORATION That he is of: <br />a corporation which is making the foregoing proposal: <br />❑JOINT VENTURE That ho is of, ���• <br />one of the parties nn aaldnngg the foregoing proposai as a,joint venture; and the ho/sho has <br />been and Is duly vested with the authority, to execute instruments for all on behalf of the <br />parties making said bid who arc: <br />that such a bid is genuine and not collusive or share, 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 or any other person, <br />Signature of Bidder <br />Subscribed and sworn to before me this day of Matte 20 e6 <br />Signature of officer Administering Oath (Notary Public) <br />}R <br />1sPNCMAN CallNotary Punlic • California <br />Los Angeles County € <br />b , A Commission N 2242.835 <br />" My Comm, Expires Jun 14, 2022 <br />P-6 of P-16 <br />23A-72 <br />