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ALL AMERICAN ASPHALT (21)
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ALL AMERICAN ASPHALT (21)
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Last modified
11/8/2019 7:08:26 AM
Creation date
11/8/2019 7:02:05 AM
Metadata
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Template:
Contracts
Contract #
17-6885
Agency
Public Works
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT CIVIL CODE § 1189 <br /> A notary public or other officer completing this certificate verifies only the identity of the 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 Riverside <br /> On October 9, 2019 before me, B. Royster, Notary Public <br /> Date Here Insert name and Title of the Officer <br /> personally appeared Edward J. Carlson <br /> Name(ker5ignes <br /> 9 <br /> who proved to me on the basis of satisfactory evidence to be the <br /> B.ROYSTER person(s) whose name(s) is/are subscribed to the within instrument <br /> = Notary and acknowledged to me that he/she/the executed the same in <br /> ry Public-California 9 y <br /> Riverside County f. his/her/their authorized capacity(es), and that by his/her/their <br /> Commission+Y 2260352 signature(s) on the instrument the person(s), or the entity upon behalf <br /> My Comm.Expires Oct 26, 2022 of which the person(s)acted, executed the instrument. <br /> I certify under PENALTY OF PERJURY under the laws of the State of <br /> California that the forgoing paragraph is true and correct. <br /> WITNESS m and a official seal. <br /> Signature <br /> Place Notary Seal Above Si ture of Notary Public <br /> OPTIONAL <br /> Though the information below is not required by law, it may prove valuable to person relying on the document <br /> and could prevent fraudulent removal and reattachment of this form to another document. <br /> Description of Attached Document <br /> Title or Type of Document Payment Bond—City of Santa Ana <br /> Document Date: October 15, 2019 Number of Pages: 3 <br /> Signer(s) Other Than Named Above: Rebecca Haas-Bates, Attorney-in-Fact <br /> Capacity(ies)Claimed by Signer(s) <br /> Signer's Name: Edward J. Carlson Signer's Name: <br /> o Individual o Individual <br /> X Corporate Officer—Title(s): Vice President o Corporate Officer—Title(s): <br /> o Partner r ❑ Limited o General o Partner L ❑ Limited ❑General <br /> RIGHT THUMBPRINT RIGHT THUMBPRINT <br /> ❑Attorney in Fact OF SIGNER ❑Attorney in Fact OF SIGNER <br /> o Trustee Top of thumb here Top of thumb here <br /> ❑Trustee <br /> o Other: ❑ Other: <br /> Signer is Representing: Signer is Representing: <br /> All American As.halt <br />
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