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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 THE FOUNTAINS <br />AND PLAZA OF T14E FLAGS <br />OWNERSHIP AFFIDAVIT <br />STATE, OF CALIFORMA ) <br />COUNTY OF ORANGE <br />G:l FV OF 5AN 'A ANA ) <br />le x Y!� I ! \ �2 C/J%/ being duly sworn„ deposes and says: <br />❑ INDIVIDUAL Thai he/she is the party malting the foregoing proposal: <br />❑ PARTNERSHIP That he/she is a member of the co -partnership firm designated as: <br />and who has been tinct Is duly vested with the authority to Malta and execute instruments <br />for the copartnership by: <br />who constitute the other members of the co -partnership. <br />[CORPORATION That he is of,. <br />a a,, porafion which is ma 'np, thefm•egoin' p, posal: <br />❑.POINT- 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 the <br />parties making said bill who are: <br />that such a bi is genuine and not collusive or sham, and has not in any manner sought by <br />collusio to s cure any advantag against the City of Santa Ana or any person interested in the <br />prol7 , ed cont ct, for himself Q any other person. <br />Si�Talr6rcofd3rd'e '— <br />Subscribed and sworn to before me this day of1�lG 20 <br />Signature of officer Administering Oath (Notary Public) <br />P-6 of P-16 <br />