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GALLEGOS BROTHERS LLC
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Last modified
3/25/2024 3:55:47 PM
Creation date
1/8/2013 3:44:04 PM
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Contracts
Company Name
GALLEGOS BROTHERS LLC
Contract #
A-2012-206
Agency
PUBLIC WORKS
Council Approval Date
10/1/2012
Destruction Year
2019
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CALIFORNIA ALL-PURPOSE <br />CERTIFICATE OF ACKNOWLEDGMENT <br />State of California <br />County of OmIlArn c <br />On June 1312os'i beforeme, <br />lc� lZ-c>a�az <br />personally appeared 125va a^I90 <br />who proved to me on the basis of satisfactory evidence to be the persono whose nameg(Is/are subscribed to <br />the within instrument and acknowledged to me that &she/they executed the same in&/her/their authorized <br />capacity, and that by her/their signature•K on the instrument the person(< or the entity upon behalf of <br />which the person(Kaeted, 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 />W "1N l nd and official seal. <br />Signature of Notary Public <br />_ use- -•--- <br />,:. GASTON FEDERICO ROBERTI-r <br />COMM. # 1823285 <br />NOTARY PUBLIC CALIFORNIA iC <br />ORANGE COUNTY N <br />(Notary Seat_ �71My cornm. expires Nov. 18, 2012 e <br />ADDITIONAL OPTIONAL INFORMATION <br />DESCRIPTION OF THE ATTACHED DOCUMENT <br />i`90 C�atwl�3)ncj <br />(Title or description of attached document) <br />(Title or description of attached document continued) <br />Number of Pages Document Dateb-t3"17_ <br />>u[A <br />(Additional information) <br />CAPACITY CLAIMED BY THE SIGNER <br />❑ <br />Individual (s) <br />❑ <br />Corporate Officer <br />(Title) <br />❑ <br />Partner(s) <br />❑ <br />Attorney -in -Fact <br />❑ <br />Trustee(s) <br />❑ <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 a document so long as the <br />verbiage does not require the notary to do something that is illegal far a notary in <br />California (i.e. certifying the authorized capacity of the signer). Please check the <br />document carefuAy for proper notarial wording and attach this form 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 signer(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 />he/sInithey— is /are) 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 />2008 Version CAPA 02.10.07 800-873-9865 www.NotaryC]asses.com <br />
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