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EXCEL PAVING COMPANY
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Last modified
1/23/2024 3:28:52 PM
Creation date
1/12/2017 12:24:27 PM
Metadata
Fields
Template:
Contracts
Company Name
EXCEL PAVING COMPANY
Contract #
15-6848
Agency
Public Works
Council Approval Date
11/15/2016
Destruction Year
2021
Notes
PROJECT
Document Relationships
23B - PROJ - BICYCLE BLVDS
(Amends)
Path:
\Agenda Packets / Staff Reports\City Council (2004 - Present)\2016\11/15/2016
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CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT <br />A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to <br />which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. <br />State of California <br />County of Los Angeles <br />Onbefore me 1 r A. Henderson, Notary Public <br />�-- � ,Notary Public, <br />(Here insert name and title of the officer) <br />personally appeared C. P. Brown <br />who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) isi`WC subscribed to <br />the within instrument and acknowledged to Inc that he/s,*/tl* executed the same in his/b*tlKr authorized <br />capacity(ies), and that by his/hyt/tlXr signature(s) on the instrument the person(s), or the entity upon behalf of <br />which the person(s) acted, executed the instrument_ <br />I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph <br />is true and correct. <br />A.NENDERSON <br />ITNESS my hand and official seal.(%my <br />COMM. a2d.TOV6 N <br />Notary Public -California tt <br />LOS ANGELES COUNTY a <br />Signature of Notary Fublle <br />(Notary Seal) Comm. Expires Oct 91, 2020 <br />ADDITIONAL OPTIONAL INFORMATION <br />DESCRIPTION OF THE ATTACHED DOCUMENT <br />(Title or description of attached document) <br />(Title or description of attached document continued) <br />Number of Pages _ Document Date <br />(Additional information) <br />CAPACITY CLAIMED BY THE SIGNER <br />j] Individual (s) <br />�] Corporate Officer <br />(Title) <br />❑ Partner(s) <br />Attorney -in -Fact <br />❑ Trustee(s) <br />(] Other <br />INSTRUCTIONS FOR COMPLETING THIS FORM <br />Any acknowledgment completed in California most contain verbiage exactly as <br />appears above to the notary section or a separate acknowledgment form most be <br />properly completed and attached to that document. The only exception is if a <br />document is to be recorded outside o,J'Ca/ifornia. In such instances, any alternative <br />acknowledgment verbiage as may be printed on such a document so long as the <br />verbiage does not require the notary to do something that is illegal for a notary in <br />California (i.e. cerefying the authorized capacity of the signer). Please check the <br />document carefully for proper notarial wording and attach this form f required. <br />• State and County information must be the State and County where the document <br />signer(s) personally appeared before the notary public for acknowledgment, <br />• Date of notarization must be the date that the signers) personally appeared which <br />must also be the same date the acknowledgment is completed. <br />• The notary public must print his or her time as it appears within his or her <br />commission followed by a comma and then your title (notary public). <br />• Print the names) of document signer(s) who personally appear at the time of <br />notarization. <br />• Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. <br />he/she/they- is /are ) or circling the correct forms. Failure to correctly indicate this <br />information may lead to rejection of document recording. <br />• The notary seal impression most be clear and photographically reproducible. <br />Impression must not cover text or lines. If seal impression smudges, re -seal if a <br />sufficient area permits, otherwise complete a different acknowledgment form. <br />• Signature of the notary public must match the signature on file with the office of <br />the county clerk. <br />9 Additional information is not required but could help to ensure this <br />acknowledgment is not misused or attached to a different document. <br />Indicate title or type of attached document, number of pages and date. <br />Indicate the capacity claimed by the signer. If the claimed capacity is a <br />corporate officer, indicate the title (i.e. CEO, CFO, Secretary). <br />• Securely attach this document to the signed document <br />C 200420/5 PmLlnk Signing Serine, Inc, —AH Rights Rewired www.ThcPwLWk...—Nationwide Notary Service <br />
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