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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/ -X A,A, L- 7 , being duly 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 cc -partnership firm designated as: <br />and who has been and is duly vested with the authority to make and execute instruments <br />forthe co -partnership by: <br />who constitute the other members of the co -partnership. <br />(CORPORATION That he is of: <br />C"' �s I C d.viT#'G-i "T7 r .✓ C'- <br />a corporation which is making the foregoing proposal: <br />❑ JOINT VENTURE e That he is of: yam.- J - k <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 />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 <br />�sworn <br />nttoo before me this day of r(JMea 20 f 6 <br />Signature of officer Administering Oath (Notary Public) <br />■ — - :,.T <br />1 t. SANGMAN GH <br />Notary Public - California <br />�- Los Angeles County It <br />Commission N 2242935 <br />My Comm. Expires Jun t4, 2022 <br />www <br />P-6 of P-16 <br />