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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.; 17-6875 <br />CITYWIDE TRAFFIC SIGNAL VEHICLE HEAD UPGRADES <br />FEDERAL PROJECT NO: HSIPL 5063(188) <br />OWNERSffiP AFFIDAVIT <br />STATE OF CALIFORNIA <br />) <br />COUNTY OF ORANGE <br />) SS: <br />CITY OF SANTA ANAE�ey <br />) <br />Q,je &adh.. i P.1'i <br />l" ��d ) DtY' . , being duly sworn, deposes and says: <br />0 INDIVIDUAL <br />That he/she is the party making the foregoing proposal: <br />❑ PARTNERSHIP <br />That be/she is a member of the co -partnership fimt designated as: <br />and who has been and is duty vested with the authority to make andexecute instruments <br />for the co -partnership by; <br />who constitute iho othermembcrs ofthe copartnership. <br />®COILPORATION <br />is <br />rnajil)nal Ling Builder"$ Inn <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 be/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 shale, and has not in any manner sought by <br />collusi secure any advantage against the City of Santa Ana or any person interested in the <br />propos d ontract, fgr •myself or any other person. <br />Signature of Bidder <br />Subscribed and sworn to before me tbis day of 20 <br />�Admfinisterfingj—(Oath <br />�2�'✓ c4eclSignature ofyffa (Notary Public) <br />P-6 of P-38 <br />