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Last modified
12/11/2018 9:04:05 AM
Creation date
12/11/2018 8:57:10 AM
Metadata
Fields
Template:
Contracts
Company Name
CEM CONSTRUCTION CORPORATION
Contract #
16-6862
Agency
Public Works
Council Approval Date
10/2/2018
Document Relationships
23A - PROJ - CABRILLO PARK SIDEWALK
(Attachment)
Path:
\Agenda Packets / Staff Reports\City Council (2004 - Present)\2018\10/02/2018
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 <br />A notary public or other officer completing this certificate verifies only the identity of the individual who signed the docu ment <br />to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. <br />State of California q 1 <br />County of Loi AO -2 k J} <br />On �G / A o, IS before me, SaVI /l d Wn Oh <br />Date--rr�� ere Insert Name and Title of the officer <br />personally appeared JC'SUS C. G'Ki/i"c) <br />Name(s) of Signer(s) <br />who proved to me on the basis of satisfactory evidence to be the person(4 whose name(* is/'ai_e subscribed <br />to the within instrument and acknowledged to me that he/sig r8y executed the same in his/hsgAlTelr <br />authorized capacity(ias), and that by his/herltheir signature(s#on the instrument the person(s), or the entity <br />upon behalf of which the person(s) acted, executed the instrument. <br />` $ANGMAN OH <br />111 Notary Publle' California ll <br />Los Angeles County <br />� 7 <br />Commission # 2242935 <br />" My Comm, Expires Jun 14, 2022 <br />w�.rs.r�ww <br />Place Notary Seal and/or Stamp Above <br />I 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 <br />Signature of Notary Public <br />Completing this information can deter alteration of the document or <br />fraudulent reattachment of this form to an unintended document. <br />Description of Attached Document <br />Title or Type of Document: <br />Document Date: //2- Aj <br />Signer(s) Other Than Named Above: <br />Capacity(les) Claimed by Signer(s) <br />Signer's Name: <br />❑ Corporate Officer — Title(s): <br />❑ Partner — ❑ Limited ❑ General <br />❑ Individual <br />❑ Trustee <br />❑ Other: <br />Signer is Representing: <br />❑ Attorney in Fact <br />❑ Guardian of Conservator <br />02017 National Notary Association <br />Iff"YAMOM <br />berofPages: <br />Signer's Name: <br />❑ Corporate Officer — <br />Title(s): <br />❑ Partner — ❑ Limited ❑ General <br />❑ Individual <br />❑ Attorney in Fact <br />❑ Trustee <br />❑ Guardian of Conservator <br />❑ Other: <br />Signer is Representing: <br />
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