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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 20-2707 <br />ADAMS PARK PARKING LOT IMPROVEMENTS <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA ) <br />COUNTY OF RIVERSIDE) SS: <br />CITY OF W*i**"40M CORONA ) <br />Edward J. Carlson 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 £mn 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 />® CORPORATION That he is of: <br />a corporation which is making the foregoing proposal: <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 <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 sham, 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 />proposed contract, for mself or any other person. <br />Signature of Efidder Edward J. Carlson, Vice President <br />Subscribed and sworn to before me this <br />Signature of officer <br />(Notary Public) <br />of <br />20 <br />P-6 of P-17 <br />