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23B - PROJ - MEMORIAL PARK SECURITY
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23B - PROJ - MEMORIAL PARK SECURITY
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Last modified
7/6/2015 8:39:42 AM
Creation date
7/2/2015 4:11:29 PM
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23B
Date
7/7/2015
Destruction Year
2020
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EXHIBIT 6 <br />City of Santa Ana <br />Section 3 Business Concern Eligibility Certificate <br />Name of Business: nn Careen Giant Land cane.•Inc_ �,. �_ <br />Address of Business: V, bi I " Al ( ko 3+ - La_ OWI — 90 (gS <br />Telephone Number:Pv� <br />Type of Business: tL]'' Corporation <br />®Sole Proprietorship <br />Section 3 Business Concern Oualifvina Basis <br />Fax Number: S te D" 10 56 �1_ <br />❑Partnership <br />13 Joint Venture <br />1. 51% owned by Section 3 low- income residents; or <br />2. Permanent, full -time employees that include at least 30% Section 3 low- income or very low- <br />income residents; or <br />3. Written commitment to subcontract with more than 25 % of the dollar award of all subcontracts <br />to be awarded to business concerns) that meet either of the above (I or 2) Section 3 <br />qualifications, <br />Specify Ethnicity and Gender of Business Ownership (please check one): <br />❑ American Indian or Alaska Native 11 Asian <br />© Native Hawaiian or Other Pacific Islander ® White <br />American Indian or Alaska Native and White © Asian and White <br />Black or African American and White El Black or African American <br />1� tjmerican Indian or Alaska Native and Black or African American <br />Balance of individuals reporting more than one race <br />Gender: <br />Male 01<emale <br />Ltbi' signorine kd I declare under penalty ofp erjury that tho above information is correct. <br />Sign ur fB Date <br />ty <br />Print Name <br />Received by Date <br />23B -39 <br />
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