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OWNERSHIP AFFIDAVIT <br /> STATE OF CALIFORNIA ) <br /> COUNTY OF ORANGE )SS: <br /> CITY OF SANTA ANA ) <br /> T _ Curtis P. Brown III ,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 for the co- <br /> partnership by: <br /> who constitute the other members of the co-partnership. <br /> [CORPORATION That he is of pc;etipOrt PALP, INC IDDA <br /> EXCEL PAVING COMPANY <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 he/she has been and is duly <br /> vested with the authority to execute instruments for an on behalf of the 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 collusion to <br /> secure any advantage against the City of Santa Ana or any person interested in the proposed contract, for <br /> himself or ny other person. <br /> 1- , i.�..®_ Fords P. Brown III <br /> ls+ President <br /> Sigh tune of Bidder <br /> Subscribed and sworn to before me this day of JAN u 0 2024 20 <br /> Signature of officer Administerin ath otary Public) <br /> 6.COVINOTON <br /> COMM.42339602 ua� <br /> °a `; Notary Public-California ¢ <br /> . >k !'t' LOS ANGELE5 COUNTY u. <br /> My Comm.Expifes Dee 8,2024 <br /> City of Santa Ana RFP 23-182 <br /> Page A3-7 <br />