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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.09-3213 <br />CENTENNIAL PARK NEIGHBORHOOD WATER MAIN IMPROVEMENTS <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA ) <br />COUNTY OF ORANGE ) 55: <br />CITY OF SANTA ANA ) <br />.� (-'D ell "" J !/1 .1 , being duly sworn, deposes and says: <br />INDIVIDUAL That he/she Is the party making the foregoing proposal: <br />❑ PARTNERSHIP 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 copartnership by: <br />who constitute the other members of the co -partnership. <br />CORPORATION That he Is of: �T j <br />a corporation which is making the foregoing proposal: <br />[]JOINTVENTURE 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 advaage against the City of Santa Ana or any person interested in the <br />proposedVnya for him If or any other person. <br />Signature of Bidder <br />Subscribed and sworn to before me this _.a_ '- day of -'�� 20 L� <br />Signature of officer Administering Oath (Notary Public) <br />P-6 of P-15 <br />SUNGNYE Y. KIM <br />o <br />COMM. Nf 9$4924 � <br />Notary Public California x' <br />Orange County <br />M Comm. Ex Tres Jul 13, 2G16y <br />23A-12 <br />