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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 17-6897 <br />FLOWER STREET BIKEWAY <br />FEDERAL PROJECT NO: HSIPL 5063 (187) <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA <br />) <br />COUNTY OF ORANGE <br />) SS: <br />CITY OF SANFA ANA <br />) <br />John Wong <br />, being duly swom, deposes and says: <br />❑ INDIVIDUAL <br />That he/she is the party making the foregoing proposal: <br />❑ PARTNERSHIP <br />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 />[RCORPORATION <br />That he is of'. <br />Vice President <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 />contract/fpr hirri4elf or any other person. <br />gom to before me this I'll" day of _M20 V <br />16119q 00�) USIA <br />of officer Administering Oath (Notary Public) <br />A notary p <br />it or other officer completing <br />this carllficatverifies only the identity of <br />the Individuall who signed the document to <br />which this cerlifkate is attached, and not <br />the truthfulness, aauracy, or validity of <br />that document. <br />a.... ELISA BETH LiM <br />ComNo. 2281637 <br />NOTARY PuatIC.CALIFORNIA <br />sAN eERNARgpO COUNTY <br />my Cam'. Ev'i .MARCH 21, 2023 <br />P-7 of P-52 <br />