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23C - C.S LEGACY FOR CIVIC CENTER IMPROVEMENTS
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12/17/2019
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23C - C.S LEGACY FOR CIVIC CENTER IMPROVEMENTS
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Last modified
12/12/2019 5:43:32 PM
Creation date
12/12/2019 5:34:01 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23C
Date
12/17/2019
Destruction Year
2024
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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 18-2679 & 18-2680 <br />CIVIC CENTER IMPROVEMENTS <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA <br />) <br />COUNTY OF ORANGE <br />) SS: <br />CITY OF SANTA ANA <br />) <br />_ nt rJ nr.+t <br />being duly sworn, deposes and says: <br />❑ INDIV IDUAL <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 />� <br />ISI ORPORATION <br />who constitute the other members ofthe co-parthership. <br />That he is of <br />e di <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 arc: <br />that such a bid is genuine and not collusive or sham, and has not in any manner sought by <br />collusion to secure y advantage against the City of Santa Ana or any person interested in the <br />proposed contract, r h self or any other person. <br />Signature of Bidder) 61770 z�� � a _ �'y��i olio f <br />Subscribed and swdm to beforemethis i0ayrif. 20 _ <br />Signature of officer Administering <br />P-230-919 <br />
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