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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 18-6613 <br />C-5-F CHANNEL REPAIR <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA ) <br />COUNTY OF ORANGE ) SS: <br />CITY OF SAgANTA ANA 11���� ) <br />N4rtCK Lrl f� Sao , 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 />Pa— <br />who constitute the other members of the co -partnership, <br />CORPORATION That yhhee is of: (.,,_ �_ ) �,� ,±^ <br />C;GCC% COVt.S '\Y 4l..0 "r Sty (wo-le <br />a corporation which is making the foregoing proposal: <br />❑ JOINT VENTURE That he is of. <br />01/� <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 />yr /a - <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 />r " osed contract, for himself or any other person. <br />f <br />Signature of Bidder <br />Subscribed and sworn to before me this day of �_ 20 1 <br />Signature of officer Administering O r (Notary otary Public) <br />P-5 ofP-15 <br />