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CITY OF SANTA ANA <br />RFP NO.: 22-096 <br />ON CALL EMERGENCY ASPHALT & PCC <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA I <br />COUNTY OF ORANGE ) SS: <br />CITY OF SANTA ANA ) <br />Michael Murray being duly swom, deposes and says: <br />❑ INDIVIDUAL That helshe 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 for the co -partnership <br />by. <br />who constitute the other members ofthe co -partnership. <br />(] CORPORATION That he is of: <br />Hardy & Harper. Inc_ _ <br />a corporation which is making the foregoing proposal: <br />❑ JOINT VENTURE That he is of: <br />one of the parties making the foregoing proposal as a joint venture, and the helshe has been and is duly vested <br />with the authority to execute instruments for an on hchalfof the parties making said bid who are: <br />that such a bid is genuine and no collusive or sham, and has not in any manner sought by collusion to secure any <br />advantage against the City of S to Ana or any person interested in the proposed contract, for himself or any other <br />person. <br />Signature C6 TRAC R <br />Michael Mu , Vice P sident <br />Subscribed and savor before me this day of <br />SEE ATTACHED <br />o icer Administering Oath (Notary Public) <br />Page 3 of 10 <br />