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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NOS.: 16-1301, 16-1302, 16-1303, 16-1304 <br />DOWNTOWN PARKING FACILITY IMPROVEMENTS <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA <br />) <br />COUNTY OF ORANGE <br />) SS: <br />CITY OF SANTA ANA <br />) <br />ERIC 0TH MAN <br />being duly swom, deposes and says: <br />❑ INDIVIDUAL <br />That he/she is the party making the foregoing proposal: <br />❑ PARTNERSHIP <br />That he/she is a member of the co -partnership fum 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 <br />That he is of <br />SECRETARY OF USS CAL BUILDERS INC. <br />a corporation which is making the foregoing proposal: <br />❑ JOINT VENTURE <br />That he is of.- <br />f- <br />- <br />one of the parties making the foregoing proposal as a joint 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 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 himself or any other person. <br />Signature of Bidder <br />Subscribed and swom to before me this day of <br />r mL i. %L- ftTaw Mo(ft'Y <br />Signature of officer Administering Oath (Notary Public) <br />P-6 of P-16 <br />23D-12 <br />20 <br />