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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 15-7538 <br />SANTA ANA REGIONAL TRANSPORTATION CENTER <br />RESTROOM RENOVATION <br />OWNERSHIP AFFIDAVIT <br />s,FATE OF CALIFORNIA ) <br />COUNTY OF ORANGE ) SS: <br />CITY OF SANTA ANA ) <br />it�-yi S �,+ , 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: <br />❑ JOINT VENTURE <br />a corporation which is <br />That he is of <br />the <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 collusive or sham, and has not in any manner sought by <br />collusi to se u e a a eragainst the City of Santa Ana or any person interested in the <br />prop e ontract, for hi - any other person. <br />Signature of Bids) <br />Subscribed and sworn to before me this da o - 20 _ <br />Signature of officer <br />P-6 of P-16 <br />23A-12 <br />