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BEN'S ASPHALT, INC. (3)
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BEN'S ASPHALT, INC. (3)
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Last modified
11/14/2024 2:56:33 PM
Creation date
5/17/2011 9:17:34 AM
Metadata
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Template:
Contracts
Company Name
BEN'S ASPHALT, INC.
Contract #
11-7530
Agency
Public Works
Council Approval Date
5/16/2011
Destruction Year
2016
Notes
Project
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT <br />crv?? coloe g ? ? sa <br />State of California <br />County of_? P? <br />On ? /S?- // before me, ?/? G. `ice ? ?j ? ??Irt? ?•?WiG , <br />Dale -? Here Insert Name and T[le of the fficer <br />personally appeared \/U`!/1 ?? - f/??? <br />Na s) of bigner(s) <br />who proved to me on the basis of satisfactory <br />evidence to be the person(s) whose name(s) is/are <br />subscribed to the within instrument and acknowledged <br />to me that he/she/they executed the same in <br />his/her/their authorized capacity(ies), and that by <br />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 />A L. F it D I certify under PENALTY OF PERJURY under the <br />CowMwissitoo ? 119 laws of the State of California that the foregoing <br />frodry Pv61fe - ICaMAmu paragraph is true and correct. <br />? Cellwyr <br />Comm. Flab 2t, 2015 <br />WITNESS my hand and official seal. <br />Signature ?r?? <br />Place Notary Seal Above ? Signature of Notary Public <br />OPT/ONAL <br />Though the information below is not required by law, it may prove va/uab/e to persons relying on the document <br />and could prevent fraudulent removal and reattachment of this form 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: <br />D Corporate Officer -Title(s): <br />C ] Individual - <br />0 Partner - C7 Limited 1. ]General Top of thumb here <br />I-] Attorney in Fact <br />U Trustee <br />C_I Guardian or Conservator <br />D other: <br />Signer Is Representing: <br />Signer's Name: <br />C] Corporate Officer -Title(s): <br />CJ Individual - <br />O Partner - O Limited L.J General Top of thumb here <br />LI Attorney in Fact <br />O Trustee <br />Cl Guardian or Conservator <br />C? Other: <br />Signer Is Representing: <br />I _J <br />Number of Pages: <br />2010 National Notary Association NationalNO[ary.org l-BOO-US NOTARY (1-BOO-B76-6B2]) Item #5907
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