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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO. 15-6836: RESIDENTIAL STREET REPAIR FY 14/15 <br />PROJECT 15-6452: WILSHIRE AVE. AND BORCHARD AVE. WATER MAIN IMPROVEMENTS <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA <br />) <br />COUNTY OF ORANGE <br />)SS: <br />CITY OF SANTA ANA <br />) <br />C.P. <br />BROWN , being duly sworn, deposes and says: <br />❑ INDIVIDUAL <br />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: PAIP MC <br />PRESIIDENI <br />a corporation which is making the foregoing proposal: <br />F1 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 />Signature of Bidder D,P� BROWN, PRESIDENT <br />Subscribed and sworn to before me this day of <br />Signature of officer ministering Oath (Notary Public) <br />(71 <br />Fh-Lih—nfL-4; MyCh.P�EMCx,PuprHbJiLrFeI1mELsbr3I OCI9'CPcaEtSOl1ift1o;Pr7AnTiYa K�mI'- <br />! <br />25, 2l1'ta� <br />BP -7 of 17 <br />20 _ <br />