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OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA <br />) <br />COUNTY OF ORANGE <br />) SS: <br />CITY OF SANTA ANA <br />) <br />John Wong <br />, being duly sworn, deposes and says: <br />❑ INDIVIDUAL <br />That he/she is the party making the foregoing proposal: <br />❑ PARTNERSHIP <br />nut 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 <br />That he is of. <br />a corporation which is making the foregoing proposal: <br />❑ JOINT VENTURE <br />That he is oC <br />one of the parties making the foregoing proposalasa 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 cq9tract, for, himself or any other person. <br />before me this aD day of 20 L <br />of offer Administering Oath (Notary Public) <br />.: Anotary pub8c or other offlcercompleling <br />3.? OLIVIACHEA thiaeertiGcateveriFlasonlytheldentityot <br /><" R?;; the Individual who signed the document to <br />Commission No.2107474 which this certificate is attached, and not <br />NOTARY PUBLIC -CALIFORNIA n the truthfulness. accuracy, or validity of <br />„a. SAN BERNARDINO COUNTY that document <br />...._..... <br />MY Comm. Expires APRIL 18.2018 <br />REBID Project 17-6893 - December 20, 2017 <br />23A-12 <br />