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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 14-6802 WARNER AVENUE STREET IMPROVEMENTS (MAIN TO OAK) <br />PROJECT NO.: 18-6424 WARNER AVENUE WATER MAIN IMPROVEMENTS (MAIN TO OAK) <br />PROJECT NO.: 20-6618 WARNER AVE STORM DRAIN IMPROVEMENTS (MAIN TO OAK) <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA ) <br />COUNTY OF ORANGE ) SS: <br />CITY OF SANTA ANA ) <br />bjZNGA0 H A A U-0V 5 L being duly sworn, deposes and says: <br />❑ INDIVIDUAL That he/she is the party making the foregoing proposal: <br />❑ PARTNERSII[P 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 />"0 ORATION That he is of: , <br />LO 1-A �12.oC V l -ijC, -- mot i t)Gpi— <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 />Co hi elf or any other pers. <br />'k4U-)�(- <br />Signa ure o <br />Subscribed and sworn to before me this day of TTAPORI—y 20 <br />Signature of officer Administering Oath (Notary Public) <br />P-12 of P-23 <br />