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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 16-6871 <br />SAFE ROUTES TO SCHOOL ENHACEMENTS FOR KING ELEMENTARY <br />STATE PROJECT NO: ATPL- 5063(160) <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA ) <br />COUNTY OF ORANGE ) SS: - <br />CITY OF SANTA ANA ) <br />Van Nguyen being duly sworn, deposes and says: <br />❑ INDIVIDUAL That he/she is the party making the foregoing proposal: <br />[]PARTNERSHIP Thathe/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 />Xj CORPORATION That he is of: <br />President of California Professional Engineering, Inc. <br />a corporation which is making the foregoing proposal: <br />❑ JOIN'T VENPURE That he is of: <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 />that such a bid is genuine and not collusive or sham, and has not in any manner sought by <br />collusion to secure any a vantage against the City of Santa Ana or any person interested in the <br />proposed contract, fol hil f or a lty other person. <br />Signature of Bidder <br />Subscribed and sworn to before me t1 s _ day of 20 <br />Signature of officer Administering Oath (Notary Public) <br />P-7 of P-17 <br />