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BEN'S ASPHALT, INC. (2)
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BEN'S ASPHALT, INC. (2)
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Last modified
11/14/2024 2:56:23 PM
Creation date
3/7/2012 11:02:07 AM
Metadata
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Template:
Contracts
Company Name
BEN'S ASPHALT, INC.
Contract #
12-2621
Agency
Public Works
Council Approval Date
3/5/2012
Destruction Year
2017
Notes
Project
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<br /> <br /> <br /> <br /> <br /> <br /> CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT <br /> <br /> <br /> State of California <br /> ss. <br /> County of <br /> ll z°l~ `~(Ll <br /> - - / before me, M <br /> On Name and Tile of Officer (e.g., "Jane Doe, Nof~ry Public") <br /> Date _y <br /> personally appeared I'{Z Name(s) of Signer(s) <br /> personally known to me <br /> <br /> ? proved to me on the basis of satisfactory evidence <br /> to be the person(s) whose name(s) is/are subscribed <br /> to the within instrument and acknowledged to me that <br /> TEr~ RI BR OEN he/she/they executed the same in his/her/their <br /> Commission # 1924994 authorized capacity(ies), and that by his/her/their <br /> aI. Notary Public California z signature(s) on the instrument the person(s), or the <br /> = g... D <br /> Orange County entity upon behalf of which the person(s) acted, <br /> M Comm.. Expires Feb 10, 2015• executed the instrument. <br /> WITNESS m and and off' ' seal <br /> C ~ <br /> Place Notary Seal Above <br /> Signature of Notary Public <br /> OPTIONAL <br /> document <br /> Though the <br /> prevent fraudulent removal law, it my prove <br /> and reattachment of this form to another document. <br /> and could <br /> Description of Attached Document <br /> Title or Type of Document: <br /> Number of Pages: <br /> Document Date: <br /> Signer(s) Other Than Named Above: <br /> Capacity(ies) Claimed by Signer(s) <br /> Signer's Name: Signer's Name: <br /> ? Individual ? Individual <br /> ? Corporate Officer - Title(s): ? Corporate Officer - Title(s): <br /> ? Partner - ? Limited ? General - ? Partner - ? Limited ? General <br /> ? Attorney in Fact Top of thumb here El Attorney in Fact Top of thumb here <br /> ? Trustee El Trustee <br /> ? Guardian or Conservator ? Guardian or Conservator <br /> ? Other: ? Other: <br /> Signer Is Representing: Signer Is Representing: <br /> 0 2004 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313-2402 Item No. 5907 Reorder: Call Toll-Free 1-600-676-6827 <br />
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