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CITY OF SANTA ANA REBID <br />PROPOSAL <br />PROJECT NO.: 17-6611 <br />CHESTNUT AVE & BUSH/CYPRESS Bili LANES <br />FAID#: U58DP005861 <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA <br />) <br />COUNTY OF ORANGE <br />)SS: <br />CITY OF SANTA ANA?Nt <br />) <br />lyc <br />Q La <br />er , being duly sworn, 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 eo-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 />N CORPORATION <br />That he is <br />of. <br />a corporation which is making the foregoing proposal: <br />❑ JOINT VENTURE <br />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 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 />�ACW _ <br />Signature of Bidder <br />Subscribed and sworn to before me this day of <br />Oath (Notary Public) <br />A nolary puel c or other oflrrnr comple0n, the; ceNM1cate vermes only the <br />laterally of the individual who signed the document to whoh this ceddreale ra atl raided <br />add not the truthfulness accuracyor validity of that document <br />State of California. County of:i Girz AKAy+Jo <br />Subscribed and sworn to (Q"It r sed) before me on this_ r day <br />of M A Rd/4. A41-1 by 6-F 1I -U - Jd- <br />proved to me on the basis of satisfactory evidence to be the <br />persoarl who appeared before me. <br />Signet ue - ' (seal) <br />P-7 of P-39 <br />Q= <br />LORRAIN MANZANAgEi <br />Comm: •21S16pp <br />NOtaty PMblic � Cali(arni,T� <br />5Yi1 selhilydinq County <br />' COfINi1; Eiglires May 2!, 2020 <br />