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City of Santa Ana <br />CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE § 8202 <br />F1 See Attached Document (Notary to cross out lines 1-6 below) <br />Ll See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary) <br />Signature of Document Signer No. I Signature of Document Signer No. 2 (if any) <br />A notary public or other officer completing this certificate verifies only the identity of the individual who signed the <br />document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. <br />State of California <br />Countv of <br />ANNEMIA-ZA140PA <br />siotar� Public - California <br />Los Antelts COUM <br />romrrissiort # 2365863 <br />cormin. Expires Jul 16, 2025 <br />Seal <br />Place Notaty Seat Above <br />Subscribed and sworn to (or affirmed) before me <br />on this r__ dav of 1140-1 C 6 . 20 Z3. <br />by Date Month Year <br />(1). /" u,4 0 -r-- <br />(and (2) <br />Name(s) of Signer(s) <br />proved to me on the basis of satisfactory evidence <br />to be the person(s) who appeared before me. <br />Signature <br />Signature of Noltt) <br />OPTIONAL <br />Though this section is optional, completing this information can deter alteration of the document or <br />fraudulent reattachment of this form to an unintended document. <br />Description of Attached Document <br />Title or Type of Document: <br />Document Date: <br />Number of Pages: — Signer(s) Other Than Named Above: <br />@2014 National Notary Association - www.NationalNotary.org - 1-800-US NOTARY (1 -800-876-6827) Item #5910 <br />IwComprehensive. Innovative. Trusted. <br />Proposal for On -Call Engineering, <br />32 <br />RFP No. 17-083 <br />