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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.; 16-6854 <br />MAPLE BIKE TRAIL SAFETY ENHANCEMENTS PHASE II <br />ATPL-5063(164) — STATE FUNDED <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA ) <br />COUNTY OF ORANGE ) SS: <br />CITY OF SANTA ANA ) <br />being duly sworn, deposes and says: <br />❑ INDIVIDUAL That he/she is the party matting the foregoing proposal: <br />❑ PARTNERSHIP That he/she is a member of the co-panmrehip firm designated as: <br />and who has been and is duly vested with the authority to make end execute instruments <br />for the co -partnership by: <br />who constitute the other members of the cc -partnership. <br />-RfCORPORATION That he is of: EBS General Engineering, Inc, <br />a corporation which is making the foregoing proposal: <br />❑ JOINT VENTURE That he is of: <br />one of the patties making the foregoing proposal as a joint venture, and the ]he/she has <br />been mid 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 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 Anti or any person interested in the <br />proposed contract, for himself or any other person. <br />'41� <br />Signature of Bidder Joseph A. Nanci, President <br />Subscribed and sworn to before me thi day of P 20 , <br />Signature of officer Administering at (Notary Public) <br />WILLIAM E. ELLIS JR. <br />Commission A 2127998 <br />" : Notary Public " 001110M18Orange County <br />Mg Comm. Expires Oct 23, 2019 <br />P-7 of P-17 <br />