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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO,: 18.6613 <br />C-5-17 CHANNEL REPAIR <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALirORNIA j <br />COUNTY OF ORANGE j SS: <br />CITY OF SANTA ANA <br />1 a'�1�'! ►�! ,26�1� , being duly: sworn, deposes and says:. <br />❑ INDIVIDUAL That he/she is the party making the foregoing proposal: Af — <br />[] PARTNERSHIP That he/she is member of the co-parmership firm designated asi <br />tLJ✓ <br />and who has been and is duly vested with theauthority to make andexecute instruments <br />for the copartnership by: <br />who constitute the other members of the co -partnership, <br />/CORPORATION That is of; <br />fJ co <br />a corporation which is making the foregoing proposal: <br />❑ JOINT VENTURE That he is of. <br />,> -,G F.uUa makng me roregoing proposal as a joint venture, and the he/she has <br />and Is duly vested with the authority to execute instruments for an on behalf of the <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 />Sro',ed contract, for i i •elfor any other person. <br />-�t�:��.rASignaure of Bidder <br />Subscribed and sworn to before me this 90 kM day of MAV 20 1 c% <br />Signature of offiear Administering 061Ci (Notary public) <br />P-5 ofP-15 <br />