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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO. 14 -7516 AND 15 -7514 <br />RESIDENTIAL STREET REPAIR FY 13/14 & 14/15 <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA ) <br />COUNTY OF ORANGE )SS; <br />CITY OF SANTA ANA ) <br />C. P. aFJ{i NN ,being duly sworn, deposes and says: <br />"E'S1'OENi- <br />❑ INDIVIDUAL That he /she is the party making the foregoing proposal: <br />El PARTNERSHIP That he /she Is a member of the co- partnership firm designated as: <br />-- <br />and who has been and is duly vested with the authority to make and execute <br />Instruments forthe co- partnership by: <br />constitute the other members of the co- partnership. <br />VCORPORATION Thathelsof: PRIMDENT <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, for himself or any other person. <br />PRESIDENT <br />Signature of BIDDER <br />Subscribed and sworn to before me this W 1 9 -1015Jay of 20 <br />Signature of off ic Administering Oath (Notary Public) <br />C. PHILLIPS <br />Cory N1d96177 N <br />^r� { •^ Notary Public 4elitoo, K <br />Lc5 ANGF Ea cDtN1'Y <br />tidy Comm. Eapo-es out.25,'LOis gP -50£15 <br />yv <br />23A -20 <br />