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Item 22 - On -Call Emergency Asphalt Concrete, Concrete, and Storm Drain Repair Services
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05/21/2024
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Item 22 - On -Call Emergency Asphalt Concrete, Concrete, and Storm Drain Repair Services
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5/16/2024 12:13:08 PM
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5/16/2024 11:38:13 AM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
22
Date
5/21/2024
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OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA ) <br />COUNTY OF ORANGE ) SS: <br />CITY OF SANTA ANA ) <br />, 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 for the co- <br />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 been and is duly <br />vested with the authority to execute instruments for an on behalf of the 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 collusion to <br />secure any advantage against the City of Santa Ana or any person interested in the proposed contract, for <br />himself or any other person. <br />Signature of Bidder <br />Subscribed and sworn to before me this day of <br />Signature of officer Administering Oath (Notary Public) <br />20 <br />City of Santa Ana RFP 23-182 <br />Page A3-7 <br />
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