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RIOS, ANTONIO DBA THE SMOG PLACE - 2013
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RIOS, ANTONIO DBA THE SMOG PLACE - 2013
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Last modified
3/25/2015 1:24:38 PM
Creation date
4/29/2014 8:54:54 AM
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Contracts
Company Name
RIOS, ANTONIO DBA THE SMOG PLACE
Contract #
A-2013-184
Agency
PUBLIC WORKS
Council Approval Date
12/2/2013
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CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT <br />CIVIL CODE § 1189 <br />State of California <br />County of 6 ai40 E <br />�—C <br />On� 2_Cv� �,p_ �'Y_,_-zt1&before me, Rase Il ✓t 6 <br />C� <br />Data I In Here Insert borne if o Na <br />e and 'tl of the Officer <br />personally appeared t (/p CY U a Z 6 `� C_ t+-,/ Ma y1,24Q 2 r, <br />ROSE ANN TRUJILLO <br />Commission # 1976956 <br />y - Notary Public - California _Z <br />Z Orange County <br />My Comm. Expires May 3, 2016+ <br />Place Notary Seal Above <br />who proved to me on the basis of satisfactory <br />evidence to be the person(s) whose ame s) (Ire <br />subscribed to the within instrument and acknowledged <br />to me thatshe /they executed the same in <br />'Mer /their authorized .g5Eacit es), and that by <br />r/their signature(s) on the instrument the <br />Mrso s), or the entity upon behalf of which the <br />e E s) 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 />WITNESS my hand and official seal. <br />Signature: 0:5k C� j <br />Signature of Notary Public <br />OPTIONAL <br />Though the information below is not required bylaw, it may prove valuable to persons relying on the document <br />and could prevent fraudulent removal and reattachment of this form to another document. <br />Description of Attached Document <br />Title or Type of Document: <br />Document Date: <br />Signer(s) Other Than Named Above: _ <br />Capacity(ies) Claimed by Signer(s) <br />Signer's Name: <br />❑ Corporate Officer — Title(s): <br />❑ Individual <br />❑ Partner — ❑ Limited ❑ General <br />❑ Attorney in Fact <br />❑ Trustee <br />❑ Guardian or Conservator <br />❑ Other: <br />Signer Is Representing: <br />2010 Nateurl Nmery Ascnrlatlnn • Nailnnawn,an, n.,. <br />of Pages: <br />Ine Na me: <br />orporate Officer — Title(s): <br />Individual <br />❑ Partner — ❑ Limited ❑ General <br />❑ Attorney in Fact <br />❑ Trustee <br />❑ Guardian or Conservator <br />❑ Other: <br />Signer Is Representing <br />RIGHI'7RUM8pRIM' <br />
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