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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 />COUNTY OF ORANGE ) SS: <br />CITY OF SANTA ANA <br />�� u Qa x 5 UmdLS�, being duly sworn, deposes and says: <br />❑ INDIVIDUAL That he/she is th777777e ply making the foregoing proposal: <br />❑ PARTNERSFIIP That he/she is a member of the co -partnership firm designated as: <br />[,CORPORATION <br />❑ JOINT VENTURE <br />that such a bid is <br />collusion to secure <br />proposed contract, i <br />Signature <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 />That he is of -- <br />a corporation which is making the foregoing proposal: <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 />genuine and not collusive or sham, and has not in any manner sought by <br />y advantage against the City of Santa Ana or any person interested in the <br />r self or any other person. <br />ww�F— pivsS �knv <br />Subscribed and sworn to before me this <br />Signature of officer Administering <br />20 <br />P-9 Of P-19 <br />