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OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA ) <br />COUNTY OF ORANGE ) SS: <br />_ <br />CITY OF SANTA ANA ) <br />-CA �f//- 54, Y ,, j , being duly sworn, deposes and says: <br />❑ INDIVIDUAL That he/she Is the party making the foregoing proposal: <br />❑ PARTNERSHIP 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 for the co- <br />partnership by: <br />who constitute the other members of the co -partnership. <br />CORPORATION That he is of: prPfI-ejeA <br />is making <br />❑ JOINT VENTURE That he is of: <br />one of the parties making the foregoing proposal as a joint venture, and the he/she has been and is <br />duly vested with the authority to execute instruments for an on behalf of the parties making said bid <br />who are: <br />that such a bid is genuine and not collusive or sham, and has not in any manner sought by collusion to <br />secure any advantage aga' t the City of Santa Ana or any person interested in the proposed contract, for <br />himself or any other pe n. <br />Signature O CTOR <br />Subscribed and worn to before me this mod' day of _L�Gfab,�r 20 -�-d <br />Signature of o cer Administering Oath otary Pub ) <br />SEONWO KIN <br />COMMA 2184302 <br />Air Cow, EXP. ttea. 22, 2J2t� <br />City of Santa Ana RFP 20-106 <br />Page Al-25 <br />