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VASILJ, INC.
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Last modified
11/14/2024 3:14:09 PM
Creation date
7/2/2013 7:27:51 AM
Metadata
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Template:
Contracts
Company Name
VASILJ, INC.
Contract #
12-6605
Agency
Public Works
Council Approval Date
6/17/2013
Notes
Project
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CALIFORNIA ALL- PURPOSE ACKNOWLEDGMENT <br />State of California <br />County of i,/uz> <br />On — I� / �/ efore me, ai) <br />Here Insert Name and Title of the Oiilcer <br />personally appeared <br />_ e VESNA PERIC <br />Commission # 1972172 9 <br />LWW,MyCornrn Notary Public • California z <br />Los Angeles County <br />rxnlrrr aj ,r; 7mc 6' <br />CIVIL CODE § 1189 <br />who proved to me on the basis of satisfactory <br />evidence to be the persons) 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 />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 />WITNE S my nd and official seal. <br />Signature: Z v <br />Place Notary OPTIONAL <br />Seal Above g d , re of Notary Public <br />Though the information below is not required by law, it may prove valuable to pe ons relying on the document <br />and could prevent fraudulent removal and reattachment of this form to another document. <br />Number of Pages: <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 />❑ Corporate Officer — Title(s): <br />❑ Individual <br />❑ Partner — ❑ Limited ❑ General Top of thumb here <br />❑ Attorney in Fact <br />❑ Trustee <br />❑ Guardian or Conservator <br />❑ Other: <br />Signer Is Representing: <br />Signer's Name: <br />❑ Corporate Officer — Title(s): <br />❑ Individual <br />❑ Partner — ❑ Limited ❑ General <br />❑ Attorney in Fact <br />❑ Trustee <br />❑ Guardian or Conservator <br />❑ Other: <br />Signer Is Representing: <br />RIGHT THUMBPRINT <br />OF SIGNER <br />Top of thumb he <br />0 2010 National Notary Association - NatlonalNotary.org • 1- 800 -US NOTARY (1- 800 - 876 -6827) Item #5907 <br />
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