23A - PROJ - BRISTOL ST WATER MAIN

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i / CITY OF SANTA ANA PROPOSAL OWNERSHIP AFFIDAVIT STATE Or CAU PORN IA ) COUNTY OF ORANGE } SS: CITY OF SANTA ANA ) Vido .Artukovieh ,being duly sworn, deposes and says: [I INDIVIDUAL That lie/ she is the party rnaldngtheforegoing proposal: []PARTNERSHIP PARTNERSHIP That he /she is a member of the co- partnershfp firm designated as': and who has been and is duly vested with the authority to make and execute Instruments for the copartnership by: who constitute the other members of the eo- partnershlp, - O CORPORATION That he Is oh, e corporation which 1, making the foregoing proposal: (JOINT VENTURE That he is oh __ — - - - ` one of the parties making the foregoing proposal es a Joint venture, and the ha /she has been and is duly vested with the authority to execute-instruments for an on behalf of the partiesmeking.said bid who are: Vido Artukovich & Son, Inc. /Vidmar, Inc. A JV that such a bid Is genuine and not collusive or sham; and has not in any manner sought by collusion to secure any advantage against the City of Santa Ana or any person interested in the proposed contract, for himself orally other person. Signature of Bidder CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE 8202 A notary public or other officer completing this certificate verifies only the Identity of the Individual who signed the document to which tills certificate is attached and not the truthfulness accuracy, or validity of that document. State of California County of Los Angeles Subscribed and sworn to (or affirmed) before me an this 16th of September, 2015 by Vido Anukovich, proved to me on the basis of satisfactory evidence to be the person who appeared before me. y r 9fAgtlN ANTU 212104 N 292191 CatrrYaafon 9 r✓ NuParyPa9Me- C91111orms Signature �= Loa Mpak1 County � 1R i mrtt. a 9rn dW 31 299 23A -13