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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO„ 16 -1305 <br />3' AND BUSH RESTROOM <br />OWNERSHIP AFFIDAVIT <br />STA'L'E OF CALIFORNIA ) <br />COUNTY OF ORANGE )SS: <br />COPY OF SANTA ANA ) <br />r - <br />�G,� <br />,being duly sworn, deposes and says'. <br />❑ INDIVIDUAL That he /she is the party maldng 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 ins tmraYt� <br />for the co- partnership by: <br />who constitute the other members of the co- partnership. <br />..CORPORATION That is of, "�`f"'t °`'` ( "t C <br />t' <br />a corporation which is making the foregoing proposal: <br />❑ JOINT VENTURE That he is of; <br />one of the parties making the fotegoing proposal as a joial, venwe, and the he /she has <br />been and is duly vested with the authority to execute instmarents for an on behalf of the <br />parties making said bid who are: <br />Oat such a bid is gems' and not collusive or sham, and has not in any manner sought by <br />collusion to secure � dvantage against the City of Santa Ana or any person interested in the <br />proposed contra�,,.� �gself or any other person. <br />G J/ <br />Subscribed d sworn to before me this le- <br />day of Me"Cy 201(l <br />Signature of officer Administering Oath (Notary Public) <br />P -6 of P -16 <br />20B -12 <br />