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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 § i ISO <br />State of California <br />County of raV1Ct <br />dd'' l <br />On� C � i ('before me, S n ✓t � I I <br />' pate l ` bet /� Here Insert Na�m+e and ' I of the Officer ' <br />personally appeared N J U t C) l �Y UI i9 Ci Ma y OAr e <br />who proved to me on the basis of satisfactory <br />evidence to be th erso (s) whose ame s (is re <br />subscribed to the within instrument and acknowledged <br />to me that t&e he /they executed the same in <br />C_his/ or/their authorize a aci (ies), and that by <br />M is er /their sl na u s) on the instrument the <br />ROSE ANN TRUJILLO so s), or the entity upon behalf of which the <br />Commission # 1976966 rs 's) acted, executed the instrument. <br />Notary Public • ColdOmb <br />Orange , Expi <br />M Comm, Ex Ires Ma 3 County 1 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: N I � Iry "� <br />Place Notary Seal Above Signature of Notary Public <br />OPTIONAL <br />Though the information below is not required by law, 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 l <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 />W. <br />❑ Partner — ❑ Limited ❑ General Top, <br />❑ Attorney in Fact <br />❑ Trustee <br />❑ Guardian or Conservator <br />❑ Other: / <br />Signer Is Representing: <br />J 2010 National Notary Association <br />of Pages: <br />Name: <br />rate Officer — Title(s): <br />'❑ Individual <br />❑ Partner — ❑ Limited Ll General Top of thumb Here <br />❑ Attorney in Fact <br />❑ Trustee <br />❑ Guardian or Conservator <br />❑ Other: <br />Signer Is Representing: <br />
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