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Appendix <br />ATTACHMENT 3-6: OWNERSHIP AFFIDAVIT <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA } <br />COUNTY OF ORANGE } SS: <br />CITY OF SANTA ANA } <br />Kellie Hurst, Vice President <br />, being duly sworn, deposes and says: <br />❑ INDIVIDUAL That he/she is the party making the foregoing proposal: <br />❑ PARTNERSFHP 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 />M CORPORATION That he is of <br />California Barricade, 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 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 secure <br />any advantage against the City of Santa Ana or any person interested in the proposed contract, for himself or <br />any other person. <br />Signature of CONTRACTOR <br />Subscribed and sworn to before me this day of 20 <br />SEE CALIFORMA NOTAnY, AT-rACRED <br />Signature of officer Administering Oath (Notary Public) <br />City of Santa Ana RFP 21-120 <br />Page A3-7 <br />