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23B - PROJ - ROADWAY REHAB
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06/16/2015
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23B - PROJ - ROADWAY REHAB
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Last modified
6/11/2015 3:48:41 PM
Creation date
6/11/2015 3:30:35 PM
Metadata
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23B
Date
6/16/2015
Destruction Year
2020
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT <br />STATE OF CALIFORNIA <br />County of t oS Angeles -_._.. �. <br />On Me 13 2015 before me, Jovana Stephenson Nota Public <br />'Date Here naert em a and Title at the Of9car <br />personally appeared William Ramirez _ __ <br />Namo(s) of & gner(s ._. <br />JOVANA STEPHEN$ N <br />C6mmisswnt9906$6g <br />,S NNtANJ1P8btltl� C6slifkir�Ia <br />S6n9SmardinoT88nt�Y <br />comm. Ex Inn; Oct 8; Zeta <br />Place Notary Seal Above <br />who proved to me on the basis of satisfactory evidence to <br />be the person(s) whose name(s) is /are subscribed to the <br />within instrument and acknowledged to me that he /she /they <br />executed the same in his/her /their authorized capacity(ies), <br />and that by his /her /their signatures) on the instrument the <br />person(s), or the entity upon behalf of which the person(s) <br />acted, executed the instrument. <br />I certify under PENALTY OF PERJURY under the laws of <br />the State of California that the foregoing paragraph is true <br />and corract._e -- °' y, <br />Witness q5y hand and <br />Signature <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 <br />Title or Type of Document: Bid Bond - McFadden Ave. to Harbor Blvd, Santa Ana <br />Document Date: May 12, 2015 Number of <br />Signers) Other Than Named <br />Capacity(les) claimed by Signer(s) <br />❑ Attorney in Fact <br />❑ Trustee <br />❑ Guardian or Conservator <br />❑ Other: <br />Signer Is Representing: <br />Signer's Name: <br />❑ Individual <br />❑ Corporate Officer— Titie(s):_ <br />❑ Partner-0 Limited ❑ General <br />❑ Attorney In Fact <br />❑ Trustee <br />❑ Guardian or Conservator <br />❑ Other: <br />Signer Is Representing: <br />® 9007 Nallonal Notary Assocladon • MM De Sob Ave., P.O. Box 2402 � Chatsworth, CA gt3l3 2402 "www.NationalNoieryorg ltom #5907 neaNer. Call Toil "Free 1.8ntl8'1fr6027 <br />23B -26 <br />
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