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CITY OF SANTA ANA RE -BID <br />PROPOSAL <br />PROJECT NO.: 17-6876 <br />CROSSWALK UPGRADES PHASE 11 <br />FEDERAL PROJECT NO: HSIPL 5063(186) <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA <br />) <br />COUNTY OF ORANGE <br />) SS: <br />CI FY OF SANTA ANA <br />) <br />John Wong <br />, being duly swum, deposes and says: <br />❑ tNDIV IDUAL <br />That he/she is the party making the foregoing proposal: <br />❑ PARTNERSI IIP <br />That he/she is a member of the co -partnership firm designated as: <br />and who has been and is duty 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 />Elecnor Belco Electric, Inc. <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 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 />eontract, for himself or any other person. <br />John <br />swom to before me this 6546 day of RbVmek! t 20 <br />s. Sit1� L-Am �7� <br />Signature of officer Administering Oath (Notary Public) <br />A notary public of other officer Completing <br />this cedifluate verifies only the identity of <br />the Indlvtdual who signed the document to <br />which this wrlificato is attached. and not <br />the truthfulness, accuracy, or validity of <br />that document. <br />--------------------- <br />ELISA BETH LIAR <br />Commission No. 2281937 <br />- A NOTARY PUBLIC-CAUFORNIA <br />BAN BERNARDINO COUNTY <br />My Comm, Expm MARCH 21. 3023 <br />20A P1 46 <br />RE -BID <br />