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23A - PROJ - SAFE TRANSIT STOPS
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23A - PROJ - SAFE TRANSIT STOPS
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Last modified
6/2/2016 4:29:48 PM
Creation date
6/2/2016 3:46:42 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
6/7/2016
Destruction Year
2021
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CI'T'Y OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 15 -6843 <br />SAFE TRANSIT STOPS <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA } <br />COUNTY OF ORANGE. ) SS: <br />CITY OF SANTA ANA } <br />Michael Martin .being duly sworn, deposes and says: <br />Ej INDIVIDUAL That he /she is the party making the foregoing proposal: <br />❑ PARTNERSI HP 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- paruers-hip by: <br />who constitnue the oIIter nrembers of the co- partnership. <br />[k] CORPORATION That he is of: <br />PreeidenC <br />a corporation which is making the foregoing proposal: vv - -- <br />❑ IO[Nr VENTURE That he is of. <br />one of the parties ntaldng 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 teon'ract, him if or an ther erson. <br />Signahu of Bidder <br />Subscribed dSw ntibeforemethis._ 2E;tl, day of APr.7_i - -. -- -2016 <br />Signature of officer Administering Oath (Notary Public <br />mm NICK MARTIN <br />Commisslon # 1978731 <br />Notary Public � Callfarnia z <br />z " Orange County a <br />a "'° My Comm: Gxplras fJ�ay 27, 2016 <br />�f -' 2 <br />
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