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20A - AA BUSH ST BICYCLE BLVD
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Last modified
6/11/2020 5:01:23 PM
Creation date
6/12/2020 2:55:39 PM
Metadata
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
20A
Date
6/16/2020
Destruction Year
2025
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CALIFORNIA ALL- PURPOSE <br />CERTIFICATE OF ACKNOWLEDGMENT <br />Lnotary public or other officer completing this certificate verifies only the identity <br />individual who signed the document'to which this certificate is attached, <br />t the truthfulness, accuracy, or validity of that document. <br />State of California <br />County of Los Angeles } <br />go <br />before me, R. Covington, Notary Public <br />-- - re nsn items en a ry <br />personally appeared _ Curtis P. Brown III <br />who proved to me on the basis of satisfactory evidence to be the person(s) whose <br />name(s) is/axe subscribed to the within instrument and acknowledged to me that <br />he/six Aiwy executed the same in his/W' M*r authorized capacity(ies), and that by <br />his/bealmdr signature(s) on the instrument the person(s), or the entity upon behalf of <br />which the person(s) acted, executed the instrument. <br />I certify under PENALTY OF PERJURY under the laws of the State of California that <br />the foregoing paragraph is true and correct. <br />WITNESS my hand and official seal. <br />(Notary Public Seal) <br />A IIOI IIIIII IO/ III IIIIII 11Sol Niglio 916 <br />"a R. COVINCaTON <br />COMM.OVIN 67907 <br />TON <br />NOTARY PUBLIC - CALIFORNIA <br />LOS ANGELES COUNTY <br />My Commission Expires 06/24/2020 <br />711UIIIIaO1111tl UII IIIIIIH NI OIIP <br />ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM <br />7wisform complias with current California sramaes regarding notary wording and, <br />DESCRIPTION OF THE ATTACHED DOCUMENT Ifneeded should be completed andanached to the document. Acknowledgments <br />from other states may be completed for documents being sent to that state so long <br />as the wording does not require the Catbibrafa notary to violate California notary <br />law. <br />Mile or description of attached document) • State and County information most be the State and County where the document <br />signer(s) personally appeared before thermury public for acknowledgment <br />• Date of notarization must be the date that the signer(s) personally appeared which <br />(rue ordesclipodon of attached document continued) must also be the same date the acknowledgment is completed. <br />• The notary public must print his or ha name as it appears within his or her <br />Number Of Pages — Document Dates commission followed by a mamma and then your title (notary public). <br />• Print the name(s) of document signer(s) who personally appear at the tune of <br />notarisation <br />CAPACITY CLAIMED BY THE SIGNER <br />❑ Individual (s) <br />)D( Cc orate Officer <br />?resident <br />(Title) <br />❑ Partner(s) <br />❑ Attorney -in -Fact <br />❑ Trustee(s) <br />❑ Other <br />• Indicate the correct singular or plural forms by crossing off incorrect forms (Le. <br />he/shelWey;- is /we ) or circling the correct fours. Failure to correctly indicate this <br />information may lead to rejcetion of document recording. <br />• The notary seal impression most be clear and photographically reproducible. <br />Impression most not coca tent or lines. If seal impression smudges, re -seal if a <br />sufficient area pertains, otherwise complete a diffawt aclmowledgment form. <br />• Signatum of the notary public most match the signature on file with the office of <br />the county clarlL <br />A Additional information is not required but could help to ensure this <br />acknowledgment is not misused or attached to a different document <br />{ Indicate title or type of attached docurnent, number of pages and date. <br />q- Indicate the capacity claimed by the signer. If the claimed capacity is a <br />M ' di at th titl CEO CFO S <br />corporate o cer, m c e e a (r.e. ecntary). <br />2015 Version www.NotaryClssses,com 800-873-9865 __ _Securely attach this document to the signed document with a stapla. <br />
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