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Item 20 - Agreements for On-Call Emergency Asphalt and Concrete Services
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05/02/2023 Regular & HA
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Item 20 - Agreements for On-Call Emergency Asphalt and Concrete Services
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3/28/2024 11:14:07 AM
Creation date
8/10/2023 1:50:48 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Clerk of the Council
Item #
20
Date
5/2/2023
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CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT <br />A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to <br />which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. <br />State of California <br />County of Los Angeles <br />On kc_Q Ck Zy Z073before me, Myisha Monique Riven, Notary Public , Notary Public, <br />1 (Here insert name and title of the officer) <br />personally appeared Curtis P. Brown III <br />who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/* subscribed to <br />the within instrument and acknowledged to me that he/s)e/tP& executed the same in his/t*/their authorized <br />capacity(ies), and that by his/l*/th* signature(s) on the instrument the person(s), or the entity upon behalf of <br />which the person(s) acted, executed the instrument. <br />I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph <br />is true and correct. <br />WITNESS my hand and official seal. <br />Signature of Atary Public <br />MYISHA MONIQUE RIVEN <br />COMM. #2377053 an <br />IL Notary Public-Califomia # <br />LOS ANGELES COUNTY <br />(Notary Seal) ra <br />. , My Comm. Expires Sep 30, 2025� <br />a e�aQc a <br />ADDITIONAL OPTIONAL INFORMATION <br />DESCRIPTION OF THE ATTACHED DOCUMENT <br />(Title or description of attached document) <br />(Title or description of attached document continued) <br />Number of Pages Document Date <br />(Additional information) <br />CAPACITY CLAIMED BY THE SIGNER <br />❑ Individual (s) <br />❑ Corporate Officer <br />(Title) <br />❑ Partner(s) <br />❑ Attorney -in -Fact <br />❑ Trustee(s) <br />❑ Other <br />INSTRUCTIONS FOR COMPLETING THIS FORM <br />Any acknowledgment completed in California must contain verbiage exactly as <br />appears above in the notary section or a separate acknowledgment form must be <br />properly completed and attached to that document. The only exception is if a <br />document is to be recorded outside of California. In such instances, any alternative <br />acknowledgment verbiage as may be printed on such a document so long as the <br />verbiage does not require the notary to do something that is illegal for a notary in <br />California (i.e. certifying the authorized capacity of the signer). Please check the <br />document carefully for proper notarial wording and attach this form if required. <br />• State and County information must be the State and County where the document <br />signer(s) personally appeared before the notary public for acknowledgment. <br />• Date of notarization must be the date that the signer(s) personally appeared which <br />must also be the same date the acknowledgment is completed. <br />• The notary public must print his or her name as it appears within his or her <br />commission followed by a comma and then your title (notary public). <br />• -Print the name(s) of document signer(s) who personally appear at the time of <br />notarization. <br />• Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. <br />he/she/firer is /are ) or circling the correct forms. Failure to correctly indicate this <br />information may lead to rejection of document recording. <br />• The notary seal impression must be clear and photographically reproducible. <br />Impression must not cover text or lines. If seal impression smudges, re -seal if a <br />sufficient area permits, otherwise complete a different acknowledgment form. <br />• Signature of the notary public must match the signature on file with the office of <br />the county clerk. <br />Additional information is not required but could help to ensure this <br />acknowledgment is not misused or attached to a different document. <br />d Indicate title or type of attached document, number of pages and date. <br />4- Indicate the capacity claimed by the signer. If the claimed capacity is a <br />corporate officer, indicate the title (i.e. CEO, CFO, Secretary). <br />• Securely attach this document to the signed document <br />C 2004-2015 ProLink Signing Service, Inc. — All Rights Reserved www.TbeProLinkcom — Nationwide Notary Service <br />
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