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23A - PROJ - ELECTRIC PARK
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03/21/2017
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23A - PROJ - ELECTRIC PARK
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Last modified
3/16/2017 4:00:09 PM
Creation date
3/16/2017 3:49:07 PM
Metadata
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
3/21/2017
Destruction Year
2022
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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 14 -7513 <br />PACIFIC ELECTRIC PARK <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA ) <br />COUNTY OF ORANGE ) SS: <br />CITY OF SANT AN ,,, ) <br />9'� �4A,✓,O -i 4 , being duly sworn, deposes and says: <br />[]INDIVIDUAL That lie /she is the patty inaldrtg the foregoing proposal: <br />❑ PAR'I'NERSHI.P That he /she is a member of the co- partnership firth 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 />129 CORPORATION That he is of, President ofLEHMAN CONSTRUCTION, 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 and is drily 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 gen ' e bd not collusive or sham, and has not in any manner sought by <br />collusion to seC1 e an adv it against the City of Santa Ana or any person interested in the <br />propose¢1 f29r tr• ct, f Intl elf or any other person. <br />Subscribed and sworn to before me this day of 20 _ <br />Signature of officer Administering Oath (Notary Public) <br />Alle orcherafficarcompletingthiscertlf icate.v.....6onlythe <br />who signed the document to which this c9rtificate and not the truthfulness, accuracy, 0r validity of that document. <br />State of California <br />f.'bunty 0 blwa.u..a�a® <br />Saburibad and sworn to (of affirmed) before me this r ... 1— dait <br />ol��rxO� IrY�� r" '����9�,n✓ <br />proved to me an the bath <br />of satisfactory eYlden'a be the personX who appeared before me, <br />signataee'•�`� >�n <br />seal <br />,.p 3Hf q I4l <br />L 124 <br />MARK W. MABTCRs <br />NbiARY PUpLIC • CALIFORNIA <br />GCN1MISSION #9103987 <br />ORANCC COUNTY <br />r My comm, Cxp, APrll 11, 2019 <br />
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