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PSOMAS-A-2020-076-03
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PSOMAS-A-2020-076-03
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Last modified
5/13/2020 11:51:49 AM
Creation date
5/6/2020 4:23:23 PM
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Contracts
Company Name
PSOMAS
Contract #
A-2020-076-03
Agency
PUBLIC WORKS
Council Approval Date
4/21/2020
Expiration Date
4/21/2023
Insurance Exp Date
1/1/1900
Destruction Year
2028
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ATTACHMENT 3-1: NON -COLLUSION AFFIDAVIT - CONTINUED <br />CALIFORNIA JURAT GOVERNMENT CODE § 8202 <br />A notary public or other officer completing this certificate verifies only the identity of the Individual who signed <br />the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. <br />State of California <br />Countyof O" 4F, <br />i(�c7 xou,yr,mnr-c+nrami+ s <br />�.+ Or+nSn County <br />Commisslen X R6i]f 5 <br />' �y Comm. r+eirzr ao u, mn ' <br />Place Notary Seat and/or Stamp Above <br />Subscribed and sworn to (or affirmed) before me on <br />this Z^'k day of -)0.vrkCY , 20 ZO by <br />Date Month Year <br />(1) �F.C',Ube-YL �E t_✓bl=rn O <br />(and (2) ), <br />Nome(s) of Signers) <br />proved to me on the basis of satisfactory evidence to <br />be the person(s) who appeared before me. <br />Signature � N�tC aL <br />Signature of Notary Public <br />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: <br />Document Date: <br />Signer(s) Other Than Named Above: <br />02019 National Notary Association <br />Number of Pages: <br />RFP No. 19.113 -, - - _ . i Mill of Santa Ana PSOMAS <br />
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