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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO. I5-6840; WARNER AVENUE PAVEMENT MAINTENANCE <br />PROJECT NO. 16-685$: FIRST STREET PAVEMENT MAINTENANCE <br />OWNERSHIP AFFIDAVIT <br />STATE OF CALIFORNIA } <br />COUNTY OF OR -ANEW- ss; <br />CITY OF -SAN -T -A-N* <br />being duly sworn, deposes and says; <br />❑ INDIVIDUAL That he/she is the party making the foregoing pZm <br />❑ PARTNERSHIP That he/she is a member of the ca -partnership ated as. <br />and who has been and is duly v with the authority to make and execute instruments <br />for the co -partnership by: <br />who constitute the er members of the co -partnership. <br />5�(CORPORATIDN That he is of: r <br />kvt <br />4ti u rt'Sti e <br />a corporation which is making the foregoing proposal: <br />❑ JOINT VENTURE That he is of: <br />one of the parties making the fore ing proposal as a,joint venture, and the he/she has <br />been and is duly vested witl t " uthority to execute instruments for an on behalf or the <br />parties making said bid wh ar . <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 />proposed contract, for himself or any other person. <br />Signa re of Bidder -s .Cank r", �k <br />Subscribed and sworn to before the this day of 20 <br />Signature of officer Administering Oath (Notary Public) <br />P-7 of P-17 <br />