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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 16 -2651 <br />CIVIC CENTER RE- CAULKING EXPANSION JOINTS AT PLAZA OF THIS FOUNTAINS <br />AND PLAZA OF THE FLAGS <br />OWNERSHIP AFFIDAVIT <br />STATE, OF CALIFORNIA I <br />COUNTY OF ORAN L I SS: <br />CITY OFF SAN" 'A ANA ) <br />�/ kex —T adc I! f�-, (i1 / 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 Grin 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 co- parmeitship. <br />[XCORPORATTON That he is of: <br />El JOINT VENTURE That he is or: <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 bi is genuine and n t collusive or sham, and has not in any manner sought by <br />Coll to s cure any advantag against the City of Santa Ana or any person interested in the <br />prop ed cont act, for himself9 any other person. <br />of <br />Subscribed and sworn to before me this day of /I 20 <br />IT <br />Signature of officer Administering Oath (Notary Public) <br />P -6 of P -16 <br />23A -12 <br />