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Item 20 - Fountain Maintenance Repair Services
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10/17/2023 Regular
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Item 20 - Fountain Maintenance Repair Services
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Last modified
10/11/2023 4:14:58 PM
Creation date
10/11/2023 3:17:56 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
20
Date
10/17/2023
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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 before me, E. Johnson _ _ , Notary Public, <br />Date Insert Name of Notary exactly as it appears an t€ie ofNc€a€ sea€ <br />personally appeared Sandra R. Black <br />ame(s) of S`sgnef 75 <br />E. JOHNSO <br />.; r. . <br />COM 92310061 K <br />WARY RUBRIC � CAW QlilIIA <br />s�CRAMENTO C04J TY <br />Comm, & . OCT. 22 2023 <br />who proved to me on the basis of satisfactory evidence to <br />be the person(s) whose name(s) is/are subscribed to the <br />within instrument and acknowledged to me that he/she/they <br />executed the saute in hts/her/the€r authorized capacity(les), <br />and that by hisiherltheir 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 official Weal, <br />Place Notary Seal AboveSignature <br />of Not ub€€c . <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 f•audulent removal and reat0chment of the farm 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 />Capacity(ies) Claimed by Signer(s) <br />Signer's Name:.�endlra R. Black <br />CJ Individual <br />❑ Corporate Officer----11tle(s) <br />❑ Partner ❑ Limited ❑ General <br />Attorney in Fact <br />❑ Trustee <br />❑ Guardian or Conservator <br />❑ Other: <br />Signer is Representing: <br />fiery Mutual insurance _ <br />_.. insurance CompenV ....�:.- <br />Number of Pages: <br />Signer's Name: <br />❑ Individual <br />❑ Corporate Officer—Title(S); <br />❑ Partner ❑ Limited ❑ General <br />❑ Attorney in Fact <br />❑ "trustee <br />❑ Guardian or Conservator <br />0 Other: <br />Signer is Representing: <br />
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