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Item 18 - City Hall 3rd Floor Tenant Improvements
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04/05/2022 Special and Regular & HA
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Item 18 - City Hall 3rd Floor Tenant Improvements
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City Clerk
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Agenda Packet
Agency
Clerk of the Council
Item #
18
Date
4/5/2022
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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 22-1401 <br />SANTA ANA CITY HALL — THIRD FLOOR - TENANT IMPROVEMENTS <br />OWNERSHIP AFFIDAVIT A notary public or other officer completing this <br />certificate verifies only the identity of the individual <br />STATE OF CALIFORNIA } who signed the document to which this certificate <br />COUNTY OF ORANGE )SS,,. is attached, and not the Iruthfulness accuracy. or <br />CITY OF SANTA ANA validity of that document. <br />-vr C)�uq _ , being duly swom, 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 <br />for the co -partnership by: <br />who constitute the other members of the co -partnership. <br />F-� CORPORATION That he is of. <br />President of ALLINONE CONSTRUCTION INC. <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 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, for himself or any other person. <br />r <br />Signature of Bidder <br />Subscribe artd-swo before me this day of 20 �Z <br />Signatur cer A Bring Oath (Notary Public) <br />s` r CINDY E. HOISINGTON <br />k=* <br />Notary Public - California x <br />Orange County b <br />�c <br />r• My <br />Commission ; 2381044 <br />Comm. Expires Nov 28, 2025 <br />P-6 of P-17 <br />
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