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ALTAMED HEALTH SERVICES
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Last modified
1/10/2025 9:05:05 AM
Creation date
12/7/2023 5:33:24 PM
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Template:
Contracts
Company Name
ALTAMED HEALTH SERVICES
Contract #
N-2023-330
Agency
Planning & Building
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CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189 <br />A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document <br />to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. <br />State of California County ofytm I <br />On pckmv" l , 2p23 before me, Abjgwli 4. WON, Notary r*jj(, <br />Date Here Insert Name and Title of the Officer <br />personally appeared low R. Batdh <br />Nome(s) of Signers) <br />who proved to me on the basis of satisfactory evidence o be the person(s) whose names are subscribed <br />to the within instrument and acknowl ged to me that 6'she/they executed the same in 1 /her/their <br />authorized capacity(ies), and that by /her/their signature(s) on the instrument the person(s), or the entity <br />upon behalf of which the person(s) acted, executed the instrument. <br />0M/ABIUL Y. ALCALA <br />Notary P-0lic-CaliforniaOrange County <br />Commission w 2317212 <br />y Comm. Expires Dec 26, 2023 <br />Place Notary Seal and/or Stamp Above <br />I certify under PENALTY OF PERJURY under the <br />laws of the State of California that the foregoing <br />paragraph is true and correct. <br />WITNESS my hand and official <br />Signature <br />OPTIONAL <br />Notary Public <br />Completing this information can deter alteration of thVdocument or <br />fraudulent reattachment of this form to an unintended document. <br />Description of Attached Document <br />Title or Type of Document: Af ft U111% Sel%(ek,- 1'(D?" MOTItf Afr, Nm+- <br />Document Date: <br />Signer(s) Other Than Named Above: <br />Capacity(ies) Claimed by Signer(s) <br />Signer's Name: <br />❑ Corporate Officer — Title(s): <br />❑ Partner— ❑ Limited ❑ General <br />❑ Individual ❑ Attorney in Fact <br />❑ Trustee ❑ Guardian or Conservator <br />❑ Other: <br />Signer is Representing: Cj" Odd (Aa <br />Number of Pages: <br />Signer's Name: <br />❑ Corporate Officer — Title(s): <br />❑ Partner— ❑ Limited ❑ General <br />❑ Individual ❑ Attorney in Fact <br />❑ Trustee ❑ Guardian or Conservator <br />❑ Other: <br />Signer is Representing: <br />^xtrr ... n.»..a ',�. .,.�,. ..-.�-... t�r-,�. v-:... ",..>.s �o-,:o-to- �-<-.,�, vy.> ....:-,�„�..a o->-<�;.ti ......... ... ..p•.ey>1a <br />02018 <br />
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