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23B - PROJ - CIVIC CENTER STORMWATER LIFT STATIONS
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07/16/2019
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23B - PROJ - CIVIC CENTER STORMWATER LIFT STATIONS
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Last modified
7/11/2019 5:30:54 PM
Creation date
7/11/2019 5:24:31 PM
Metadata
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23B
Date
7/16/2019
Destruction Year
2024
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ARNAZ ENGINEERING CONTRACTORS, INC. (5)
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\Contracts / Agreements\ PROJECTS
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE 1189 <br />A nolar} public or other officer completing this certificate verifics only the identityof the individual who signed the <br />document to which this certificate is attached and not the truthfulness, accuracy. or validi[y of that document. <br />State of California ) <br />Coun <br />t <br />y of Orange _ ) <br />Oil —1 `� ��. before me, Natassia Kirk -Smith Notar} Public, <br />personally appeared Vanessa Copeland <br />Name(s) orSigner(,$) <br />who proved to me on the basis of satisfactory evidence to be the person(s) chose narne(s) is/are subscribed to the <br />lvithin instrument and acknowledged to me that he/she/flit-c- executed the same in his/hor/tlrvir authorized <br />capacity(ies), and that by his/herltbeir signature(s) on the instrument the person(s), or the entity upon behalf of <br />which the person(s) acted, executed the instrument. <br />NATASSIA KIAK.SMITH <br />!' " N;�: <br />: i 7_ <br />Notary Public California <br />_ ```���-o���.�F <br />orange County i <br />COmn11551P0. 22$3$18 <br />My <br />Comm, Expires Aug 12, 2022 <br />Plaice.Notary Sail Above <br />t ccrtify under PENALTY OF PERJURY usurer the <br />laws of the State of California that the 'foregoing <br />paragraph is true and correct. <br />WITNESS tnv hand and offi al al. <br />r <br />Signahrr : _ <br />signature - r Publle <br />---------------------------------------------- - ---- OPTIONAL --------------------------------------------------- <br />Though the information is not required'b}' lane, it may prove valuable to persons reh ing on the document <br />and could present fraudulent and reattachment of this form to another document. <br />Description of Attached Document <br />Type or Title of Document: <br />Document Date: <br />Signer(s) Other Than Named Above: <br />Capacity(ies) Claimed by Signer(s) <br />Signer's Name: Vanessa Copeland <br />❑ Individual <br />❑ Corporate Officer — Title(s):_ <br />❑ Partner: ❑Limited ❑ GcnQral <br />X❑ Attorney in Fact <br />❑ Trustee <br />❑ Guardian or Conservator <br />❑ Other: <br />Signer Is Representing: <br />Number of Pages: <br />Capacity(ies) Claimed by Signer(s) <br />Signer's Name: ---.--.._...--__-_-- <br />❑ Individual <br />❑ Corporate OfficerTitle(s):_ <br />❑ Partner: ❑Limited ❑ General <br />❑ Attorney in Fact <br />❑ Trustee <br />❑ Guardian or Conservator <br />❑ Other: <br />Signer Is Representing: <br />Rev. 1-15 <br />23B-17 <br />
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