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Item 10 - New Traffic Signal Installation at Chestnut Avenue and Zoo Lane (Formerly Elk Lane)
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01/16/2024 Regular & Special HA & Special SA
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Item 10 - New Traffic Signal Installation at Chestnut Avenue and Zoo Lane (Formerly Elk Lane)
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1/23/2024 9:02:45 AM
Creation date
1/17/2024 4:39:50 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
10
Date
1/16/2024
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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 23-6999 <br />TRAFFIC SIGNAL INSTALLATION AT CHESTNUT AVENUE AND ELK LANE <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA ) <br />COUNTY OF ORANGE )SS-. <br />CITY OF SANTA ANA ) <br />Ted Baker 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 <br />for the co -partnership by: <br />who constitute the other members of the co -partnership. <br />❑ CORPORATION That he is of: <br />Baker Electric & Renewables LLC <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 himself or any other person. <br />Signature of Bidder <br />Subscribed and sworn to before me this �,-12 temher day of <br />Signature of officer Administering Oath (Notary Public) <br />19 2023 <br />P-7 of P-18 <br />
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