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CITY OF SANTA ANA <br />PROPOSAL <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA ) <br />COUNTY OF ORANGE ) SS: <br />CITY OF SANTA ANA /� ) <br />L-t , 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 <br />instruments for the co- partnership by: <br />who constitute the other members of the co- partnership. <br />CORPORATION That he is of: <br />i114 _. <br />4 5 % is 1 KCC' l V\ C <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 <br />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 <br />collusion to secure any advantage against the City of Santa Ana or any person interested in the <br />proposed contract, fpAimself or any other person. <br />Signature of <br />Subscribed and sworn to before me this day of 20 <br />Signature of officer 40ministering Oath (Notary Public) <br />('14 o C, <br />SutlonJ bProgrsel09 -22 -2014 <br />P -2 <br />23A -29 <br />