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Date <br />ATTEST: <br />W. E. ST JOHN, County Clerk of the County <br />of Orange and ex officio Clerk of the Board <br />of Supervisors of Orange County <br />By <br />Deputy <br />STATE OF CALIFORNIA <br />COUNTY OF ORANGE <br />On this — day of <br />said County and State, personally appeared <br />COUNTY OF ORANGE <br />By <br />Chairman, Board of Supervisors <br />1 19 —, before me, a Notary Public in and for <br />as —Chairman of the Board Of Supervisors of Orange County, <br />California, who is known to me to be the person described in and whose name is subscribed to the <br />within instrument, and acknowledged to me that he executed the same on behalf of said County of <br />Orange and as Such officer thereof. <br />IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal the day and <br />year in this certificate first above written. <br />APPROVALS <br />Approved as to form by <br />County Counsel on March 3, 1965 <br />F 108 1 -5 <br />