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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 16 -2671 <br />BOMO K.ORAL SIDEWALK RENOVATION <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA ) <br />COUNTY OF ORANGE ) SS: <br />CITY OF3MN* Placentia ) <br />Ronnie Cochran being duly sworn, deposes and says: <br />[i 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 <br />Golden Stage Constructors ----------------- <br />a corporation which is making the foregoing proposal: <br />❑ JOINT VENTURE That he is of: <br />one of the parties mating the foregoing proposal as ajoint 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 malting 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 himself or any other person. <br />Subscribed and w`8i , o before me this r day of Pec� 24+6— <br />Signature of officer Administerin ath (Notary Public) <br />If, I <br />J <br />