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CITY OF SANTA ANA ADDENDUM NO. ONE <br />PROPOSAL <br />PROJECT NO.: 20-7535 <br />LOCAL URB RAMP IMPROVEMENTS (PHASE II} <br />OWNERSHIP AFFIDAVIT <br />STATE 0I7 CAI.IVORNIA ) <br />COUNTY OF ORANGE, ) SS: <br />CITY OF SANTA ANA <br />Vido L. Samar aiGti being duly sworn, deposes and suys4 <br />INDIVIDUAL That he/she Is dra party making the foregoing, proposal: <br />tI PAW17NERSUIP That he/she is a inentbor of the co -partnership Ann designuedas:- <br />slid who hasJaeen and is duly vested with die authority to inalco end execute instiilluents <br />for the co-purfnetship by: <br />who constitute the other members ofthe co -partnership. <br />2CORPORATION That he Is of; VJdO S&iT1�rZIOh,.LC ,_,_,_ <br />a corporation whiolt isauaking theforegaing proposal: <br />El JOINT VENTURE That he is off,. <br />one of the parties making the 11m%oing -propose[ its a joint venture, and the he/she has <br />been unit Is duly vested with the authority to execute instruments for an on behalf of the <br />parties making said hid who arc: <br />that such a bid Is genuine and not collusive or share, and has not in any manner sought by <br />collusion to secure any advantage against the City of Santa Ana or any person interested in the <br />propose nt c for himself or any other person. <br />Signature o der <br />Subscribed and sworn to before me this day of 20 <br />s'%7 <br />Signature of officer Administering Oath (Notary Public) <br />P-5 of P-16 <br />