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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 23-6626 <br />OCFA FIRE STATION 470 REMODEL, ADA RESTROOM AND GENERATOR UPGRADE <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA ) <br />COUNTY OF ORANGE ) SS: <br />CITY OF SANTA ANA ) <br />Ron Shashua , being duly sworn, deposes and says: <br />®INDIVIDUAL That he/she is the party making the foregoing proposal: $ 573,000 <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 />a corporation which is malting 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 whe 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 />Signature of Bidder <br />Subscrib swo efore me this 9th day of January 20 25 <br />ALn�� �- <br />Signature of officer dministering Oath (Notary Public) <br />1GM STBL <br />Notary Public - California <br />_ Ventura County <br />° Commission # 2387741 <br />My Comm. Expires Dec 21, 2025 <br />P-6 of P-18 <br />