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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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;z • •. r A ;+ r M l A' <br />a <br />STATE OF CALIFORNIA <br />County of Los Angeles <br />On Mav 13. 2015 before me, Jovana Stephenson Notary Public <br />Date here insert al�me and'rit a of thn Icer <br />personally appeared William Ramirez Nalno(s) of Slgnons) <br />JOVANA STEPHENSON <br />Commission # 1955660 <br />`r Notary Public • California <br />San Bernardino county <br />M Comm. Ex ire$ Oct 6, 2015 <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 signature(s) 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 correct./" -'""moo <br />Witness l hand and <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: Non Collusion Affidavit- McFadden Ave. to Harbor Blvd. Santa Ana <br />Document Date: May 12 2015 Number of Pages: 1 <br />Signer(s) Other Than Named <br />Capacity(ies) Claimed by Signer(s) <br />Signer's Name: William Ramirez <br />0 Individual <br />[9 Corporate Officer— Title(s):Presidant <br />0 Partner-0 Limited 0 General <br />0 Attorney in Fact <br />0 Trustee <br />0 Guardian or Conservator <br />0 Other: <br />Signer Is Representing: <br />Signer is Representing: <br />02097 Na9onal Nolary Aasaoiaon, 9350 De Solo Ave.,PA,aox 2402• Chatsworth, CA 013132402•wvnv.NaVonelMotary.arti Item45907 reorder: Cell TclWree 1.806-876.6827 <br />23B -36 <br />
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