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23A - PROJ - BRISTOL ST REHAB
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10/01/2019
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23A - PROJ - BRISTOL ST REHAB
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Last modified
9/26/2019 7:48:04 PM
Creation date
9/27/2019 4:09:12 PM
Metadata
Fields
Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
10/1/2019
Destruction Year
2024
Document Relationships
R.J. NOBLE COMPANY (3)
(Message)
Path:
\Contracts / Agreements\ PROJECTS
ROCKFORCE CONSTRUCTION, LLC
(Message)
Path:
\Contracts / Agreements\ PROJECTS
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CALIFORNIA ACKNOWLEDGMENT <br />CIVIL CODE § 1189 <br />A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document <br />to which this certificate is attached, and not the truthfulness, accuracy, or validityof that document. <br />State of California i <br />County of ORAN(,F 1} <br />On <br />06/25/19 before me, J. DE IONGH, NOTARY PUBLIC <br />Date ere Insert Name and Title oft the Officer <br />STEVEMENDOZA <br />personally appeared <br />Names) of Signer(s) <br />who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/" subscribed <br />to the within instrument and acknowledged to me that he/shekhey executed the same in hi;merin;vir <br />authorized capacity(ies), and that by his/her4hair signature(s) on the instrument the person(s), or the entity <br />upon behalf of which the persons) acted, executed the instrument. <br />.! DE IONGH <br />ion 2! <br />�n <br />Place Notary Seal ondror Stomp 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 />OPTIONAL <br />of Notary Public <br />Completing this information can deter alteration of the document or <br />fraudulent reattachment of this form to on unintended document. <br />Description of Attached Document <br />Title or Type of Document: <br />Signers) Other Than Named Above: <br />Capacity(ies) Claimed by Signer(s) <br />Signer's Name: <br />o Corporate Officer — Title(s): <br />❑ Partner — ❑ Limited ❑ General <br />O Individual ❑ Attorney in Fact <br />❑ Trustee ❑ Guardian or Conservator <br />❑ Other: <br />Signer Is Representing: <br />Number of Pages: <br />Signer's Name: <br />❑ Corporate Officer — Title(s): <br />❑ Partner — ❑ Limited D General <br />O Individual O Attorney in Fact <br />❑ Trustee ❑ Guardian or Conservator <br />❑ Other: <br />Signer is Representing: <br />[ - elrisB97srta@I�aBBBIPiIs) <br />C2018 National Notary Association <br />23A-17 <br />
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