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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 16-2653 <br />CIVIC CENTER RENOVATE ADA ACCESS <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA ) <br />COUNTY OF ORANGE ) SS: <br />CITY /OF SANTA ANA <br />•'7� ) <br />V 01'1 (d <br />A L • Ft'r Y(� e ✓r; Q ✓I , being duly swom, deposes and says: <br />❑ INDIVIDUAL That he/she is the parry 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 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 />XCORPORATION That he is of: <br />?bPSiGCCtt{ 0�- G✓tzyl(.Cattlsc'ai7z/(Nc.- <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 a joint 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 />co n to secure any advantage against the City of Santa Ana or any person interested in the <br />opose ontract, for elf or any other person. <br />Signature of Bi der <br />Subscribed and swte s day of 20 4 <br />Si a of icer n' g Oath (Notary Public) a " ° NOSIE TCLEOC•XENOERSON� <br />Cotata, 8 2086732 r^ <br />N $ i NOTARY PUNUO-CALIFORNIA VI <br />Los ANGELES COUNTY <br />r m.VC MY COM Err. Nov. fE,1018^' <br />P-7 of P-17 <br />23A-14 <br />