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23A - PROJ - WATER MAIN IMPROVEMENTS
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12/02/2014
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23A - PROJ - WATER MAIN IMPROVEMENTS
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Last modified
11/26/2014 3:00:25 PM
Creation date
11/26/2014 2:51:39 PM
Metadata
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
12/2/2014
Destruction Year
2019
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CALIFORNIA JURAT WITH AFFIANT STATEMENT <br />7X See Attached Document (Notary to cross out lines 1 -6 below) <br />See Statement Below (Lines 1 -5 to be completed only by document signer[s], not Notary) <br />............ ' <br />f <br />Signature of Document Signer No. 1 <br />State of California <br />County of ORANGE _ <br />JAN C. IMORAN <br />C6MI�. #1967021 <br />G I fM j "_^'i NorARYPUBI.IC- CALIFORNIA ) <br />'T'hy ORANGE COUNTY - <br />Comm. Exp. FEB, 17, 2016 <br />Place Notary Seal Above <br />Signature of Document Signer No. 2 (It any) <br />Subscribed and sworn to (or affirmed) before me on this <br />29TH day of SEPTEMBER 20 14 _, by <br />Date Month Year <br />(1) CHARLES L. FLAKE <br />Name of Signer <br />proved to me on the basis of satisfactory evidence <br />to be the person who appeared before me (.) (,) <br />(and - <br />Name of Signer <br />proved to me on the basis of satisfactory evidence <br />to be the pers'o�n who appeared before me.) <br />Signature l,/ y!Tj � I <br />USignature of Notary Public <br />%ally <br />Though the information below is not required by law, it may prove _ <br />valuable to persons relying on the document and could prevent <br />fraudulent removal and reattachment of this form to another document. Top of thumb here Top of thumb here <br />Further Description of Any Attached Document <br />Title or Type of Document- __- <br />Document Date: _ - -_ Number of Pages: ----- <br />signers) Other Than Named Above: <br />02007 National Notary Association, 9350 De Soto Ave., P.O. Box 2402- Chalaworth, CA 91313 -2402• aeay NatonalNotaryorg Item #5910 Reorder: Call Toll Free 1- 800 -876 -6827 <br />23A -32 <br />
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