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23A - NEW PARK AT 6TH & LACY
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03/05/2019
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23A - NEW PARK AT 6TH & LACY
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Last modified
2/28/2019 7:30:27 AM
Creation date
2/28/2019 7:25:13 AM
Metadata
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
3/5/2019
Destruction Year
2024
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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 18-2692 <br />NEW PARK AT 6TH AND LACY STREET <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA ) <br />COUNTY OF ORANGE ) SS: <br />CITY OF SANTAANA) <br />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 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 That he is of: <br />1b -, j ms 11.1 r d bcr kr c D vvc, <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 />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 />Signatur Bidder <br />Subscribed and sworn to before me this day of - NO VU, / 20 <br />4 0 ,- <br />Signature of officer Administering Oath (Notary Public) <br />AN H. HOUSTON <br />Nalary PUhRc-Ca@cmia <br />`'*.: LosArgdes Ccvrh( <br />'- A <br />22 M3 <br />My2omm,€ phea9c115.2021 <br />
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