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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 I SS: <br />CITY OF SANTA ANA ) <br />". DfYOtyiY , being duly sworn, deposes and says: <br />PFIESIDEM <br />❑INDIVIDUAL That he/she is the party making the foregoing proposal: <br />❑ PARTNERSHIP <br />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 <br />That he is of: PRESIDENT <br />a corporation which is making the foregoing proposal: <br />❑JOINT VENTURE <br />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 />C. P. SBOW 1`4 <br />PREGIOENT <br />Signature of BIDDER <br />Subscribed and sworn to before me this � ay of <br />Signature of offic Administering Oath (Notary Public) <br />c. PHauPs �f <br />COMM. tk194617"7 n <br />P'dotary PubIIC California <br />Los ANCkLES CSIUNTY a <br />My cvmm. Explras Dos. 2cJ,�616 BP -5 of 15 <br />—�> <br />20 <br />