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Agenda Packet_2026-01-20
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Agenda Packet_2026-01-20
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1/14/2026 2:29:05 PM
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City Clerk
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Agenda Packet
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City Council
Date
1/20/2026
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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 24-6053 <br />SANTA ANA FIRE STATION 74 FUEL STATION REPLACEMENT <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA <br />) <br />COUNTY OF ORANGE <br />) SS: <br />CITY OF SANTA ANA <br />) <br />Richard Camacho <br />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 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 />at he. of: <br />President of GEMS Environmental Management Services, Inc. <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 been <br />and is duly vested with the authority to execute instruments for an on behalf of the parties <br />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 <br />to secure any advantage against the City of Santa Ana or any person interested in the proposed <br />contract, for himse o aner person. <br />r <br />Sig6ature of Bdder <br />Subscribed and sworn to before me this day of <br />Signature of officer Administering Oath (Notary Public) <br />SEE ATTACHED NOTARIAL CERTIFICATE <br />20 <br />City Council P-7 ofP26— 13 1/20/2026 <br />
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