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Last modified
12/5/2019 10:48:54 AM
Creation date
7/24/2018 10:46:37 AM
Metadata
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Contracts
Company Name
NV5
Contract #
A-2018-160-04
Agency
PUBLIC WORKS
Council Approval Date
6/19/2018
Expiration Date
6/18/2021
Insurance Exp Date
5/1/2020
Destruction Year
2026
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CALIFUMA JURAT WITH AFFiANT STATEMENT OOVERNMIxNT CODE § Uo2 <br />�l+IDPd <br />Ky%@ Attached Occupant (Notary to areas Put Imes 1-6 below) <br />M 806 Statement [9aWw (tinaii 1-0 to be completed only by documont signer(q not Notary) <br />Signature oPOooument Sipner7Jo. I Sighakes al Daaument Blgnor Np, 2 (Ifany) <br />A notary PAW or other offloor completing tilts canitleAte. v0000 only the Idontiry of the Indlvidual who signed the <br />document to which this oediticate is attached, And not the talihfulaoss,eceumq or validity of that document, <br />olme of t.41ROmla <br />County of - <br />"aamk <br />—Q Va_ <br />„ Co nrt <br />T ,! NG <br />c r omly <br />wr T,.r05,152312011) <br />0ubocribod. and 8Wom to (or eftlemod} boloee me <br />on this f 5 day of i'lalcL? 20 / <br />by D�ata ^ , rytanthr� 1'aar <br />(11., IJA Vij NI �a P1'A' <br />(and <br />Nama�ia ci3ldnar(sf �- <br />Proved to me oil the basis of tarafaotory eviderros <br />10 be the p-arrssoonn;4 who appeared before me. <br />Signature—.— &� <br />9lgnataYa of Nrzrarl/pGbllc �- <br />Beef <br />place Notary SaslAbove <br />OP'ITONAL <br />--- <br />ihouph this section Is optional, 00POP aNnty @ds foliennaffon can doterailmrsuon of the dcoumont or <br />Im"a"fent reattachment of this form to an unintended dooument. <br />Description of Alto <br />chars ponipment <br />Title or Type Of Document;rV/.,'r V5%on F, av)i- , Document Oate: <br />Number of POP=,_,__ Signer(s) Other Than Named Above; <br />acaucresxxawc . - °uo<,gc ,n�� <br />M4 Naflonal Notary Association, ommNatipnalNotery.org • 1-800-08 NOTARY (1.600.076.6027) Itpin 95910 <br />
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