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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO. 09-3213 <br />CENTENNIAL PARK NEIGHBORHOOD WATER MAIN IMPROVEMENTS <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA ) <br />COUNTY OF ORANGE ) SS: <br />CITY OF SANTA ANA pf ) <br />� �---'� , being duly sworn, deposes and says: <br />❑ INDIVIDUAL That he/she is the party making the foregoing proposal: <br />❑ PARTNERSHIP That he/she is a member of the co -partnership firm designated as: <br />ally wno nas Deen and is duly vested with the authority to make and execute <br />instruments for the co -partnership by: <br />who constitute the other members of the co -partnership. <br />CORPORATION That he is of: <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 <br />the 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 adva tage against the City of Santa Ana or any person interested in the <br />proposed contra, for him If or any other person. <br />Signature of Bidder <br />Subscribed and sworn to before me this a4lk day of F" 20 /� <br />Signature of officer Administering Oath (Notary Public) <br />P-6 of P-15 <br />•�� SUNGRYE Y. KINI <br />COMM. #7984924 z <br />rc Notary Public California <br />I <br />Oranga County � <br />M Comm. Ex ires.lul 13, 2016~ <br />