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Item 22 - On -Call Emergency Asphalt Concrete, Concrete, and Storm Drain Repair Services
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05/21/2024
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Item 22 - On -Call Emergency Asphalt Concrete, Concrete, and Storm Drain Repair Services
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Last modified
5/16/2024 12:13:08 PM
Creation date
5/16/2024 11:38:13 AM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
22
Date
5/21/2024
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CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT <br />A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to <br />which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. Y <br />State of California <br />County of Los Angeles <br />On PiZ � ?__(, , U Z before me Myisha Monique Rivers, Notary Public <br />(}sere insert name and title of the -officer), Notary Public, <br />personally appeared Curtis P. Brown III <br />who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/a)t subscribed to <br />the within instrument and acknowledged to me that he/sale/t* executed the same in his/*/tb* authorized <br />capacity(ies), and that by his/*/th* 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 the foregoing paragraph <br />is true and correct. <br />WITNESS my hand and official seal. <br />Signature of Not Public <br />MYISHA MONiQUE RIVEN <br />ro r COMM. #2377053 to <br />Notary Public -California <br />U. <, LOS ANGELES COUNTY a <br />(Notary Seal) . My Comm. Expires Sep 30, 2025 <br />ADDITIONAL OPTIONAL INFORMATION <br />DESCRIPTION OF THE ATTACHED DOCUMENT <br />(Title or description of attached document) <br />(Title or description of attached document continued) <br />Number of Pages Document Date <br />(Additional information) <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 />INSTRUCTIONS FOR COMPLETING THIS FORM <br />Any acknowledgment completed in California must contain verbiage exactly as <br />appears above in the notary section or a separate acknowledgment form must be <br />properly completed and attached to that document. The only exception is if a <br />document is to be recorded outside of California. In such instances, any alternative <br />acknowledgment verbiage as may be printed on such ❑ document so long as the <br />verbiage does not require the notary to do something that is illegal for a notary in <br />California (i.e. certifying the authorized capacity of the signet). Please check the <br />document carefully for proper notarial wording and attach this forum if required, <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 notarization must be the date that the signer(s) personally appeared which <br />must also be the same date the acknowledgment is completed. <br />• The notary public must print his or her name as it appears within his or her <br />commission followed by a comma and then your title (notary public). <br />• Print the name(s) of document signcr(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 />lie/she/4 wy; is late ) 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 and 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 the capacity claimed by the signer, if the claimed capacity is a <br />corporate officer, indicate the title (i.e. CEO, CFO, Secretary), <br />• Securely attach this document to the signed document <br />C 2004-2015 Pror.ink Signing Service, Inc. — All nights Reserved w .TheProl-ink.cum — Nationwide Notary Service <br />
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