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PAVEMENT COATINGS CO. (2)
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PAVEMENT COATINGS CO. (2)
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Last modified
10/23/2018 9:22:51 AM
Creation date
5/23/2018 9:27:14 AM
Metadata
Fields
Template:
Contracts
Company Name
PAVEMENT COATINGS CO.
Contract #
17-6882
Agency
Public Works
Council Approval Date
6/20/2017
Document Relationships
23B - AWARD CONTRACT TO PAVEMENT COATINGS CO.
(Attachment)
Path:
\Agenda Packets / Staff Reports\City Council (2004 - Present)\2017\06/20/2017
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CALIFCWAIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 <br />Anotary public orother officer completing this certificate verifies only the identify ofthe individual who signed the <br />document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. <br />State of California <br />County of Orange <br />On before me, <br />Date <br />pa,anna]l/ appeared <br />A. Slone, Notary Public <br />Here Insert Name and Ptfe of the Officer <br />Richard LWells <br />of <br />who proved to me on the basis of satisfactory evidence to be the person(% whose narneW is/are <br />subscribed to the within instrument and acknowledged to me that hWsw#� executed the same in <br />or the entity upon behalf of which the person(�) acted, executed the instrument. <br />I certify under PENALTY OFPERJURY under the laws <br />of the State cfCalifornia that the foregoing paragraph <br />intrue and correct, <br />LYNN A. SLONE WITNESS n/yhand and official seal. <br />Notary Pu 1n; - California <br />Orange County <br />Commission # 2134740 Signature— <br />MY Comm, Lxplre$ Dec 16. 201q Isig,nature of Notary Public <br />Place Notary Seal Above <br />OPTIONAL <br />Though this section Is optional, completing this information can deter alteration ufthe document or <br />fraudulent reattachment ufthis form tomnunintended document. <br />Description of Attached Document <br />Title orType ofDocument: Document Date: <br />Number n|Pages: _______Qignor(s)Other Than Named Above: _________ <br />Cmpmnity(ies) Claimed bySigner(s) <br />Signer's Name: <br />['Corporate Officer ~-Tit|o�): <br />[]Pu�nwr--[)Lirnited !]Genorel <br />L. Individual []/NtonneyinFact <br />F' Trustee [] Guardian orConservator <br />E Other: <br />Signer |oRepresenting <br />Signer's Name: <br />L]Corporate Officor--Tit|e(s): <br />[]Partner - - []Linnited El General <br />F.1 Individual [] Attorney inFact <br />!]Trustee []Guardian urConservator <br />Signer |wRepresenting: <br />0%O14National Notary Association `www.NutiunalNoturyurg^1^&O0^U8NOTARY (1'800'870~M827) |tom#5907 <br />
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