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23A - PROJ - ROADWAY IMPROVEMENTS
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06/21/2016
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23A - PROJ - ROADWAY IMPROVEMENTS
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Last modified
6/20/2016 9:44:25 AM
Creation date
6/16/2016 3:23:48 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
6/21/2016
Destruction Year
2021
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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO,: 16 -6868 <br />WARNER INDUSTRIAL COMMUNITY PAVEMENT IMPROVEMENTS <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA <br />) <br />COUNTY OF ORANGE <br />) SS: <br />CITY OF SANTA ANA <br />) <br />STEVE MENDOZA <br />, being duty sworn, deposes and says: <br />E] INDIVIDUAL <br />That he /she is the party making the foregoing proposal: <br />[] PARTNERSHIP <br />That he/she is a member of the copartnership 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 copartnership. <br />® CORPORATION <br />That he is of <br />SECRETARY OF R.J. NOBLE COMPANY CALIFORNIA CORPORATION <br />a corporation which is making the foregoing proposal: <br />JOINT VENTURE <br />That he is of, <br />one of the parties making the R <br />been and is duly vested with the <br />parties making said bid who are: <br />proposal as a joint venture, and the he /she has <br />to execute instruments for an on behalf of the <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 />Subscribed and swolAtk before me this 3RD day of NOVEMBER 20 15 <br />— <br />Signature of <br />Commission # 2128504 <br />Notary Public - California <br />Orange County <br />Oath (Notary Public) <br />p' . e ' R <br />
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