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23A - PROJ - EDINGER ST REHAB
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11/19/2019
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23A - PROJ - EDINGER ST REHAB
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Last modified
11/14/2019 7:40:49 PM
Creation date
11/12/2019 2:35:52 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
11/19/2019
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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 19-6946 <br />EDINGER AVE. REHABILITATION: RAITT ST. TO BRISTOL ST. <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA I <br />COUNTY OF"j"" F Riverside I SS: <br />CITY OF 91"#FOrr"tA <br />Corona I <br />Edward J. <br />Carlson , 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 />®CORPORATION <br />That he is of.. <br />Vice President of All American Asphalt <br />a corporation which is making the foregoing proposal: <br />❑ JOINT V ENTURE <br />That he is of: <br />one of the parties making the foregoing proposal as ajoint venture, and the he/she has been <br />and is duly vested with the authority to execute instruments for an on behalf of the parties <br />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 collusion <br />to secure any advantage against the City of Santa Ana or any person interested in the proposed <br />contract, for himself or person. <br />Signof/Bidder Edward J. Cdrl, VirreNPrgsid 1 <br />Subscribed and swom V before mVeuthhi�s{� ��/ day of 20 <br />'Please See Attached <br />Signature of officer Administerin')%,Qath (Notary Public) <br />P-7 of P-17 <br />
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