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CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT <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 Sacramento <br />On <br />]-IS 70V before me, E. Johnson <br />Rat Insert Name of NOW exactly as it appears on the official seal <br />personally appeared Sandra R. Black <br />Name(s) of Signer(s) <br />E. JOHNSON <br />COMM. # 2310061 10 <br />NOTARY PUBLIC • CALIFORNIA <br />mi SACRAMENTO COUNTY'' <br />Comm. Exp. OCT. 22 2023 <br />, Notary Public, <br />who proved to me on the basis of satisfactory evidence to <br />be the person(s) whose name(s) islare subscribed to the <br />within instrument and acknowledged to me that he/she/they <br />executed the same in his/her/their authorized capacity(ies), <br />and that by his/her/their signature(s) on the instrument the <br />person(s), or the entity upon behalf of which the person(s) <br />acted, executed the instrument. <br />I certify under PENALTY OF PERJURY under the laws of <br />the State of California that the foregoing paragraph is true <br />and correct. <br />Witness my hand and o icial t3eal. <br />Signature <br />Place Notary Seal Above Signature of Notary ublic <br />OPTIONAL <br />Though the information below is not required by law, it may prove valuable to persons relying on the document <br />and could prevent fraudulent removal and reattachment of the form to another document. <br />Description of Attached Document <br />Title or Type of Document: <br />Document Date: <br />Signer(s) Other Than Named Above: <br />Capaciity(ies) Claimed by Signer(s) <br />Signer's Name: Sandra R. Black <br />❑ Individual <br />❑ Corporate Officer—Title(s): <br />❑ Partner ❑ Limited ❑ General <br />d Attorney in Fact <br />❑ Trustee <br />❑ Guardian or Conservator <br />❑ Other: <br />Signer is Representing: <br />Liberty Mutual Insurance <br />Company/The Ohio Casual <br />Insurance Company <br />Number of Pages: <br />Signer's Name: <br />❑ Individual <br />❑ Corporate Officer—Ttle(s): <br />❑ Partner ❑ Limited ❑ General <br />❑ Attorney in Fact <br />❑ Trustee <br />❑ Guardian or Conservator <br />❑ Other: <br />Signer is Representing: <br />