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CITY OF SANTA AIA <br />PROPOSAL <br />PROJECT NO, 15-6606: 3RD STREET TRAFFIC CALMING (FAIR# U58DP005861) <br />OWNERSHIP AFFIDAVPI' <br />STATE OF CALIFORNIA } <br />COUNTY OF ORANGE ) SS: <br />CITY OF SANTA ANA ) <br />^ p" 'R 'hl , being duly swom, 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 />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 othermembers oftho co -partnership. W. WDIA <br />dCORPORATION That he is o£ EL ANG <br />a corporation which is making the foregoing proposal: <br />❑ JOINT VENTURE 'That he is of: <br />one of the parties making the foregoing proposalas a joint venture, and the he/;lie has <br />been. and Is duly vested with the authority to execute instruments for an on behalf of the <br />parties making said bird 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 contract, for himself or any other person. <br />' CSF,„ V1,0n, pflm!) w <br />Signature of Bidder <br />Subscribed and swo APR 11 2016 to before me this day of _ 20 — <br />Signature o" o (icer A inistering Oath (Notary Public) <br />fi tJc f hry Publk (. flfornia �y� <br />�„�"�y" tAiS ANGi tL�CpLi�IY �• <br />WIY Gomm. tx�hurb net. LTJ, 20t6 l <br />' o m ' <br />