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PAVEMENT COATINGS CO.
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Last modified
7/9/2025 8:49:16 AM
Creation date
3/30/2018 12:44:07 PM
Metadata
Fields
Template:
Contracts
Company Name
PAVEMENT COATINGS CO.
Contract #
17-6882
Agency
Public Works
Council Approval Date
6/20/2017
Expiration Date
9/29/2017
Document Relationships
23B - AWARD CONTRACT TO PAVEMENT COATINGS CO.
(Attachment)
Path:
\Agenda Packets / Staff Reports\City Council (2004 - Present)\2017\06/20/2017
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 <br />Anotary public orother officer this certificate verifies only the identity ofthe individual who signed the <br />document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. <br />State of California <br />County of Orange <br />On before me, Lynn A. Slone, Notary Public <br />Date Here Insert Name and Title of the Officer <br />po,onnW|y appeared <br />Richard LWells <br />xamo(s)m/ <br />who proved 1umeunthe basis ofsatisfactory evidence tnbothe K%whose namo0ois/are <br />ouUannood tVthe within instrument and acknowledged to nnathat he8GHef4-hexecuted the same in <br />hia/henA"irauthorized oopaoity(i+$),andthu1byhim/he*ftnsiroi a1na(�&nnihmin:trumontLhmpenoun8h' <br />or the entity upon behalf of which the person(N acted, executed the instrument. <br />I i� Orange County <br />Z Commission # 2134740 <br />My Comm, Expires Dec 16,20 19 <br />Place Notary Seal Above <br />| certify underPENALTY OFPERJURY under the laws <br />ofthe State ofCalifornia that the foregoing paragraph <br />iotrue and correct, <br />VV[7NESG my h dd fficlol seal. <br />Signature <br />Signature of Notary Public <br />OPTIONAL <br />Though this section is optional, completing this information can deter alteration of the document or <br />fraudulent reattachment of this form mmvunintended document. <br />Description efAttached Document <br />Title nrType ofDocument: Document Date: <br />Number oYPages: __,_____8igner(a)Other Than Named Above: _________ <br />Capacity(les) Claimed bySigner(s) <br />Signer's Name: <br />[]CurpormteOfficer ---UUols): <br />Partner <br />—[1Limited []General <br />[j Individual [] Attorney in Fact <br />F' Trustee |] Guardian orConservator <br />E.; Other: <br />Signer |oRepresenting: <br />Signer's Name: <br />L]Corporate Officer --Tlt|okd: <br />[jPartner --[]Limited []6wnena} <br />[||ndividuo| {]Attorney inFact <br />F_ Trustee OGuardian orConservator <br />[] Other: <br />Signer |nRepresenting: <br />08U14National Notary Association ^www,NationaiNo\ury»/8`1^0DV~USNOTARY (1'U0O~876^8A27) |tom#5907 <br />
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