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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO. 15 -6840: WARNER AVENUE PAVEMENT MAINTENANCE <br />PROJECT NO. 16 -6858: FIRST STREET PAVEMENT MAINTENANCE <br />OWNERSHIP AFFIDAVif <br />STATE OF CALIFORNIA ) <br />COUNTY OF aIbk -Nee R•,ve.ti,& ) SS: <br />CITY OF6ANT4, AN-A C.ow.w ) <br />C' rsrr\ \ Cur \sous , being duly sworn, deposes and says: <br />❑ INDIVIDUAL That he/she is the party making the foregoing <br />❑ PARTNERSHIP That helshe is a member of the co- partnershi m designated as: <br />and who has been and is duly vo etf with the authority to make and execute <br />for the co- partnership by: Zk <br />the g0ter members of the co- partnership, <br />CORPORATION That he is of: <br />a corporation which is making the foregoing proposal <br />❑ JOINr VENTURE That he is of: <br />one or the parties making the fore bing proposal as a •Joint venture, uno the he/she has <br />been and is duly vested with uthority to execute instruments for an on behalf of the <br />parties making said bid who arg. <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 himself or any other person. <br />Signat6reof \ws�Wk <br />Subscribed and sworn to before me this — day of 20 <br />�r e a�,Xl l�nLo�y- <br />Signature of officer Administering Oath (Notary Public) <br />P -7 of P -17 <br />23A -15 <br />