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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 <br />SANTA ANA ) <br />J 4 N wf'i , 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 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 other members of the co -partnership. <br />CORPORATION 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 parties making the foregoing proposal as a joint venture, and the he/she has <br />been arrd 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 Ana or any person interested in the <br />proposed contract, for <br />fffoorrhhimself or any other person. <br />Signature of Bidder Joseph A. Nanci, President <br />Subscribed and sworn to before me thi day ofT 20 <br />G <br />LU4,48 `z! 'k <br />Signature of officer Administering & (Notary Public) <br />WILLIAM E. ELLIS JR. <br />`Cammisslan � 2127999 <br />a w Notary Public • California z <br />z Orange County > <br />My Comm. Expires Oct 23, 2019+ <br />P-7 of P-17 <br />