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23A - PROJ - RESURFACING PARKS
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07/05/2016
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23A - PROJ - RESURFACING PARKS
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Last modified
6/30/2016 3:59:32 PM
Creation date
6/30/2016 3:14:29 PM
Metadata
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
7/5/2016
Destruction Year
2021
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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 16 -2668 <br />RIVERVIEW, CABRILLO & WINDSOR COURT RESURFACING <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA <br />) <br />COUNTY OF ORANGE <br />) SS: <br />CITY OF SANTA ANA <br />) <br />. Phil (.artpr <br />_ , being duly sworn, deposes and says: <br />❑ INDIVIDUAL <br />That he/she Is the party making the foregoing proposal: <br />❑ PARTNERSHIP <br />'T'hat 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 -pare ership by: <br />aho constitute the other members of the co- partnership, <br />CORPORATION <br />That he is <br />of: <br />Pacific Tennis Courts, Inc- <br />a corporation which is making the foregoing proposal: <br />❑ JOINT VENTURE <br />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 />:1,contrac b uhf or any other person. <br />igitgre ofBidder <br />Subscribed a 01' to befo'e me this day of ( } ' 20 <br />Signat officer Administering Oath (Notary Public) <br />P -7 of P -17 <br />23A -20 <br />
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