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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO. 15 -6606: 3im STREET TRAFFIC CALMING (FAID# U58DP005861) <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA ) <br />COUNTY OF ORANGF ) SS: <br />CITY OF SANTA ANA ) <br />' <br />P. 'SRO N , being duty sworn, deposes and says: <br />❑ INDIVIDUAL That he /she is the party making the foregoing proposal: <br />❑ PARTNERS$IP 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 instruments <br />for the co- partnership by: <br />who constitute the other members of the co- partnership. ~� <br />o <br />CORPORATION That r &wT EL PAVING COMW __- <br />a corporation which is making the foregoing proposal: <br />© JOINT VENTURE 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 the <br />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 <br />Subscribed and swo to before me this Ai R , .1 2016 day of <br />Signature o o ficer A tinistering Oath (Notary Public) <br />, LOv A1 Cninn fxpnrs pct. 20, ?(1161i <br />23-JAC f 4 <br />20 <br />