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CITY OF SANTA ANA <br />PROPOSAL <br />PRO.IECT NO,: 16 -6872 <br />SAFE ROUTES TO SCHOOL ENHANCEMENTS FOR WASHINGTON ELEMENTARY <br />STATE PROJECT NO: ATPL- 5063(' 161) <br />OWNERSHIP AFFIDAVIT' <br />STAiB OFCALIFORNIA ) <br />COUNTY OF ORANGE ) SS: <br />CITY OF SANTA ANA ) <br />Van Nauven being duly shorn, deposes and says: <br />INDIVIDUAL 'Chat he/she is the part% making the foregoing proposal: <br />❑ PAR TNERSHIP That he/she is a member of the eo- partnership firm designated as: <br />and who Ims been and is duly vested kvith the authority to make and execute instruments <br />for the eo- parneNiip by: <br />who constitute the other members of the co- parmei:ship. <br />E& CORPORATION That lie is of: <br />.�C2S.ICIEIIt -4� . qa.l Fn.n�i,X- 1P.�1:tIlLJ, Inr.,._ <br />a corporation which is making the t "ongoing proposal: <br />❑ JOIN'Y VENTURE ttiat he is ol`. <br />one of' tile parties making the /ongoing proposal as ajoint venture, and the he/she has <br />been and is duly Vested with the nuthorlty to execute instruments far 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 />callasion to Secure any advantage against the City of Santa Ana or any person interested in the <br />proposed other person. <br />Signature of <br />Subscribed and sworn to before roe this — day of 20 _ <br />Signature of officer Administering Oath (Notary Public) <br />P -7 of P -17 <br />23C -22 <br />