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GATES WARNER, LLC (2)
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GATES WARNER, LLC (2)
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Last modified
4/28/2022 9:24:04 AM
Creation date
11/4/2021 2:01:06 PM
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Contracts
Company Name
GATES WARNER, LLC
Contract #
A-2021-189-01
Agency
Public Works
Council Approval Date
9/21/2021
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pia: 2 [flail M i EI i <br />A notary public or other officer completing this certificate verifies only the identity <br />of the individual who signed the document to which this certificate is attached, <br />and not the truthfulness, accuracy, or validity of that document. <br />State of California <br />County of(610 0 Q e <br />On {) 2� 2o �1 before me, �'�0 1 EI 1"dt �°L �t b I Y'C <br />pp (Here l/nseed namtr and Iftlabf the hear- <br />personally appeared TWA trl CWU �4A Ck Cal MKS <br />who proved to me on the basis of satisfactory evidence to be the persons) whose <br />name(s)Safe-subscribed to the within instrument and acknowledged to me that <br />he/(i /they executed the same in4gi910/their authorized capacity(ies), and that by <br />hWJ their signature(s) on the instrument the person(s), or the entity upon behalf of <br />which the person(-s) acted, executed the instrument. <br />certify under PENALTY OF PERJURY under the laws of the State of California that <br />the foregoing paragraph is true and correct. <br />DANIELABORBE <br />WITNESS my hand and official seal. "' Notary public - Calromia <br />orange County <br />/1 Commission M 2227659 <br />My Comm. Expires Jan 31, 2 22 <br />Notary Public Signature (Ndtary Public seal) <br />y. <br />DESCRIPTION OF THE ATTACHED DOCUMENT <br />(Title or description of attached document) <br />(Title or description of attached document continued) <br />of Pages _ Document Date <br />CAPACITY CLAIMED BY THE SIGNER <br />❑ Individual (s) <br />❑ Corporate Officer <br />(Title) <br />❑ Partner(s) <br />❑ Attorney -in -Fact <br />❑ Trustee(s) <br />❑ Other <br />2015 Version www.NotaryC[asses.com 800-873-9865 <br />INSTRUCTIONS FOR COMPLETING THIS FORM <br />Thisformcompliesnvith civrent Califoneiastatutesregardingrwtaryipordingmrd, <br />if needed, should be completed and attached to the docranent. AcMumpledgntetts <br />fiam other states may be completed for docmnents being sent to that state so long <br />as the wording does not require the California notary to violate California notary <br />Imp. <br />• State and County information must be the State and County where the document <br />signer(s) personally appeared before the notary public for acknowledgment <br />• Date of notarimtion must be the date that the signers) personally appeared which <br />must also be the same date the acknowledgment is completed. <br />• Tire notary public must print his or her name as it appears within his or her <br />commission followed by a comma and than your title (notary public). <br />• Print the name(s) of document signer(s) who personally appear at the time of <br />notarization. <br />• Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. <br />he/she/they, is /are) or circling the correct forms. Failure to correctly indicate this <br />information may lead to rejection of document recording. <br />• The notary seal impression must be clear mid photographically reproducible. <br />Impression must not cover text or lines. If seal impression smudges, re -seal if a <br />sufficient area permits, otherwise complete a different acknowledgment form. <br />• Signature of the notary public must match the signature on file with the office of <br />the county clerk. <br />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 document, number of pages and date. <br />Indicate tine capacity claimed by the signer. If the claimed capacity is a <br />corporate officer, indicate the title i.e. CEO, rP177e-C-re1u-ryT- <br />• Securely attach this document to the signed document with a staple. <br />
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