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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 /> Namete rSigner(' <br /> who proved to me on the basis of satisfactory evidence to be the <br /> E,�a�r f B.ROYSTER person(s) whose name(s) is/ar-e subscribed to the within instrument <br /> <' . = Notary Public-California m and acknowledged to me that he/She/they executed the same in <br /> z s-.,y Riverside County li his/her/their authorized ca acit ies and that b his/her/their <br /> '` III Commission#2260352 p Y( ) y <br /> "'� Mysignature(s) on the instrument theperson(s), or the entityupon behalf <br /> Comm.Expires Oct 26,Z022 p <br /> 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 my and 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 /> ❑ Individual o Individual <br /> X Corporate Officer—Title(s): Vice President ❑Corporate Officer—Title(s): <br /> o Partner o Limited o General ❑ Partner r ❑ Limited o General <br /> RIGHT THUMBPRINT RIGHT THUMBPRINT <br /> ❑Attorney in Fact OF SIGNER ❑Attorney in Fact OF SIGNER <br /> ❑Trustee Top of thumb here Top of thumb here <br /> ❑Trustee <br /> ❑ Other: o Other: <br /> Signer is Representing: Signer is Representing: <br /> All American As shalt <br />
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