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CALIFORNIA PROFESSIONAL ENGINEERING, INC.
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Last modified
11/14/2024 2:59:28 PM
Creation date
6/24/2010 11:57:58 AM
Metadata
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Template:
Contracts
Company Name
CALIFORNIA PROFESSIONAL ENGINEERING, INC.
Contract #
10-6712
Agency
Public Works
Council Approval Date
6/21/2010
Notes
Project
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s <br />ALL - PURPOSE ACKNOWLEDGMENT <br />State of California <br />JJ <br />County of LAS A nQ e i -e 5 SS. <br />�� S <br />On t ►' _ + P l C' ,before me, �C O(DC- �� 0 �v� �� io i C- <br />AC-:!:j , <br />DATE <br />personally appeared aV\ N C) ',X"4 who proved to me on the <br />basis of satisfactory evidence to be the person(s) whose name(s) is /are subscribed to the within instrument <br />and acknowledged to me that he /she /they executed the <br />same in his/her /their authorized capacity(ies), and that <br />by his /her /their signature(s) on the instrument the <br />person(s), or the entity upon behalf of which the <br />person(s) acted, executed the instrument. <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 />r....r TRACY $OOC WITNESS my hand and official seal. <br />Comm. # 1841694 <br />NOTARY P"-CMFORNIA <br />t—SVIMY Los Corr. En. Junk 21, 2012'' <br />NOTARY'S SIGNATURE <br />PLACE NOTARY SEAL IN ABOVE SPACE <br />OPTIONAL INFORMATION <br />The information below is optional. However, it may prove valuable and could prevent fraudulent attachment <br />of this form to an unauthorized document. <br />CAPACITY CLAIMED BY SIGNER (PRINCIPAL) <br />❑ <br />INDIVIDUAL <br />©-'CORPORATE OFFICER <br />❑ <br />PARTNER(S) <br />❑ <br />ATTORNEY -IN-FACT <br />❑ <br />TRUSTEE(S) <br />❑ GUARDIAN /CONSERVATOR <br />❑ OTHER: <br />& 1114 <br />TITL (S) <br />SIGNER (PRINCIPAL) IS REPRESENTING: <br />NAME OF PERSON(S) OR ENTITY(IES) <br />DESCRIPTION OFATTACHED DOCUMENT <br />IJ1d (o✓1 <br />TITLE OR TYPE OF DOCUMENT <br />NUMBER OF PAGES <br />DATE OF DOCUMENT <br />RIGHT <br />THUMBPRINT <br />OF <br />SIGNER <br />OTHER <br />s <br />C <br />CL <br />0 <br />APA01 /2008 NOTARY BONDS, SUPPLIES AND FORMS AT HTTPJ /WWW.VALLEY- SIERRA.COM ® 2005 -2008 VALLEY - SIERRA INSUR -ANC'E <br />
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