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23A - AMEND FY 2019-20 ANNUAL ACTION PLAN
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23A - AMEND FY 2019-20 ANNUAL ACTION PLAN
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Last modified
1/29/2020 4:39:21 PM
Creation date
1/29/2020 4:35:00 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
2/4/2020
Destruction Year
2025
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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 20-7536 <br />RESIDENTIAL STREET IMPROVEMENT BISHOP <br />PROJECT NO.: 20-7537 <br />RESIDENTIAL STREET IMPROVEMENT RAITT <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA ) <br />COUNTY OF ORANGE ) SS: <br />CITY OF SANTA ANA ) <br />VIdo L. Samarzich , being duly sworn, deposes and says: <br />❑ INDIVIDUAL That he/she is the party staking the foregoing proposal: <br />❑ PARTNERSHIP 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 That he is of: <br />Vido Samarzich Inc <br />a corporation which is making the foregoing proposal: <br />❑ JOINT VENTURE 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 o sec re any advantage against the City of Santa Ana or any person interested in the <br />propose c ntr t for himself or any other person. <br />l <br />Sign ture of dder <br />Subscribed and sworn to before me this day of <br />SCE ATZAc. tFD <br />Signature of officer Administering Oath (Notary Public) <br />20 <br />
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