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25L - AGMT - GRAND AVE WIDENING - 208 N GRAND AVE
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25L - AGMT - GRAND AVE WIDENING - 208 N GRAND AVE
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Last modified
11/15/2012 5:39:06 PM
Creation date
11/15/2012 5:39:03 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
25L
Date
11/19/2012
Destruction Year
2017
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ALL-PURPOSE ACKNOWLEDGMENT <br />State of California <br />County of SS. <br />r?A ,L <br />On before me,1P L."Vt <br />DAVE <br />A -? <br />personally appeared 5'?? (?tJ!/1 ckUA, who proved to me on the <br />by hi-s/ er/ hem signaturw) on the instrument the <br />perso or the entity upon behalf of which the <br />personA5) acted, executed the instrument. <br />I certify under PENALTY OF PERJURY under the <br />laws of the State of California that the foregoing <br />paragraph is true and correct. <br />L. KANE <br />Comm.# 1890136 <br />WTAU A <br />N MM c a <br />Mr COW. EV. MAY 8, X9 <br />PLACE NOTARY SEAL IN ABOVE SPACE <br />WITNESS in d and official seal. <br />NOTARY'S SIGNATURE <br />OPTIONAL INFORMATION <br />The information below is optional. However, it may prove valuable and could prevent fraudulent attachment <br />of this form to an unauthorized document. <br />CAPACITY CLAIMED BY SW%NER (PRINCIPAL) DESCRIPTION OF ATTACHED DOCUMENT <br />F] INDIVIDUAL <br />? CORPORATE OFFICER <br />? PARTNER(S) TITLE(S) <br />? ATTORNEY-IN-FACT <br />? TRUSTEE(S) <br />? GUARDIAN/CONSERVATOR <br />F] OTHER: <br />SIGNER (PRINCIPAL) IS REPRESENTING: <br />NAME OF PERSON(S) OR ENTITY(IES ) <br /> <br /> <br />RIGHT r <br />THUMBPRINT D <br />OF <br />s <br />SIGNER <br /> a <br />H <br />basis of satisfactory evidence to be the person whose nan;,? a) fe subscribed t? te within instrument <br />and acknowledged to me that fie she/ executed the <br />in '/thgir authorized caacit ' s), and that <br />same P y <br />TITLE OR TYPE OF DOCUMENT <br />NUMBER OF PAGES <br />APA012008 NOTARY BONDS, SUPPLIES AZ511 4ll8://WWW.VALLEY-SIERRA.COM (02005-2008 VALLEY-SIERRA INSURANCE
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