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23A - PROJ - BRISTOL ST REHAB
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10/01/2019
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23A - PROJ - BRISTOL ST REHAB
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Last modified
9/26/2019 7:48:04 PM
Creation date
9/27/2019 4:09:12 PM
Metadata
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
10/1/2019
Destruction Year
2024
Document Relationships
R.J. NOBLE COMPANY (3)
(Message)
Path:
\Contracts / Agreements\ PROJECTS
ROCKFORCE CONSTRUCTION, LLC
(Message)
Path:
\Contracts / Agreements\ PROJECTS
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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 18-6909 <br />BRISTOL REHABILITATION FROM 17TH ST TO SANTA CLARA AVE <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA <br />) <br />COUNTY OF ORANGE <br />) SS: <br />CITY OF SANTA ANA <br />) <br />STEVE MENDOZA <br />being duly sworn, deposes and says: <br />❑ INDIVIDUAL <br />That he/she is the party making the foregoing proposal: <br />❑ PARTNERSHIP <br />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 />(:3CORPORATION <br />That he is of. SECRETARY OF R.J. NOBLE COMPANY <br />a corporation which is making the foregoing proposal: <br />❑ JOINT VENTURE <br />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 />X a' <br />Signature =%Bidder STEVE MENDOZA, SECRETARY <br />Subscribed and sw ptt : ore me this 9TH day of JULY 2019 <br />X <br />Signature of office,( Administering Oath (Notary Public) <br />J. DE IONGH I) <br />J. DE IONGH <br />+ Commission # 21 sc04 <br />Notary Public Cahrainia <br />i�e�i Orange County <br />My Comm. Expires Oct 28, 20" <br />P-6 of P-16 <br />23A-15 <br />
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