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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO,: 16-2654 <br />THORNTON PARK RF.STROOM <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA <br />1 <br />COUNTY OF ORANGE <br />1 SS: <br />CITY OF SANTA ANA <br />/ /,w o 2w y <br />�) <br />4 - /%y f L being duly sworn, deposes and says: <br />❑ INDMDUAL <br />That he/she is the party making the foregoing proposal: <br />❑ PARTNERSHIP <br />That he/she is a member of the co -partnership fine designated as: <br />and who has been and is duly vested with the authority w make and execute instruments <br />for the co -partnership by: <br />who constitute the other members of the co -partnership. <br />That he is of 1 <br />ItCORPORATION <br />L7'e L�L- %A.USj'rP u['F-)'.I 14f Sa C-ici R" f <br />_���1�C�[Jc �r CEb <br />a corporation which is making the foregoing proposal: <br />❑ JOINT VENTUR E <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 duty 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 />Ignature of Bidder <br />Subscribed and sworn to before me this day of 20 <br />Signature of officer Administering Oath (Notary Public) <br />P-7 ofP-17 <br />