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23B - BRISTOL ST REHAB
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12/17/2019
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23B - BRISTOL ST REHAB
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Last modified
12/12/2019 5:43:58 PM
Creation date
12/12/2019 5:33:35 PM
Metadata
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23B
Date
12/17/2019
Destruction Year
2024
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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 <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 Orange ) <br />On 10/14/2019 before me, Liliana Gomez, Notary Public <br />Date Here Insert Name and Title of the Officer <br />personally appeared Rcbeeca Haas -Bates <br />NameKof Signerr* <br />who proved to me on the basis of satisfactory evidence to be the persons} whose name(9). is/are <br />subscribed to the within instrument and acknowledged to me that he/she/that' executed the same in <br />Itis/her/their authorized capacity(L^rs, and that by his(her/their signature4on the instrument the person <br />or the entity upon behalf of which the person(s), acted, executed the instrument. <br />I certify under PENALTY OF PERJURY under the laws <br />of the State of California that the foregoing paragraph <br />is true and correct. <br />uLIANA GOMEZ WITNESS hand and official seal. <br />Notary Public - California <br />Orange County <br />=% Commission F 2243326 Signature..... •"'w'V <br />My Comm. Expires May 20, 2023 <br />Signature of &tary Public <br />Place Notary Seal Above <br />OPTIONAL <br />Though this section is optional, 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: Bid Bond Document Date: 10/14/2019 <br />Number of Pages: One(]) Signer's) Other Than Named Above: All American Asphalt <br />Capacity(ies) Claimed by Signer(s) <br />Signer's Name: Rebecca Haas -Bates <br />❑ Corporate Officer — Title(s): <br />❑ Partner — ❑ Limited ❑ General <br />❑ Individual WAttorney in Fact <br />❑ Trustee ❑ Guardian or Conservator <br />❑ Other: <br />Signer Is Representing: <br />Fidelity and Deposit Company of Maryland <br />Signer's Name: <br />❑ Corporate Officer — Title(s): <br />❑ Partner — ❑ Limited ❑ General <br />❑ Individual ❑ Attorney in Fact <br />❑ Trustee ❑ Guardian or Conservator <br />❑ Other: <br />Signer Is Representing: <br />are ��: _ :.�.�. .�ti.ti. a. '��. �•.�,-«. . <br />O 1 • • • • • • • • :11 • yYM :11 B. •1 <br />23B-18 <br />
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