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23A - PROJ - WATER MAIN IMPROVEMENTS
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06/16/2015
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23A - PROJ - WATER MAIN IMPROVEMENTS
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Last modified
6/11/2015 3:50:00 PM
Creation date
6/11/2015 3:30:24 PM
Metadata
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
6/16/2015
Destruction Year
2020
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cALIFORNIA ALL-PURPOSE-ACKNOWLEDGMENT CIVILVIDDE1 1180 <br />A notary public or other officer completing this certificate verifies only the Identity of the Individual who signed the <br />document to which this certficate is allac hed, and not ft "fulness, accuracy, or validity of that document. <br />State of California <br />Countyof Los Angeles <br />On MAY 1" 3 201 before me, C. Phillips, Notary Public <br />Date Here fnsert Name and litte of the Officer <br />personally appeared C. P. Brown <br />Names) of Signer(s) <br />who proved to me on the basis of satisfactory evidence to be the person(; whose name(s) isAM <br />subscribed to the within instrument and acknowledged to me that he /shmfty executed the same in <br />hisAmWilbok authorized capacity(les), and that by hislk®h Moir signatures) on the instrument the person(s), <br />or the entdy,ilpon behalf of which the person(s) acted, executed the instrument. <br />I certify under PENALTY OF PERJURY under the laws <br />of the State of California that the foregoing paragraph <br />is true and correct. <br />WITNESS my hand and official seat. <br />o r>ruLUps <br />comet xa <a�� M <br />;+, N <br />Signature <br />°n'a � " -= t�otaq Fuhilc Calitornfa � �---- <br />ucr� s cour v Signa ure of 1", Public <br />,y MY Cornet. fkplr6s Ort. 29, 7.Oi€�� <br />Place Notary Seal Above <br />OPTIONAL <br />Though this section Is optional, completing this Information can deter alteration of the document or <br />fraudulent reattachment of this form to an unintended document. <br />Description of Attached Document <br />Title or Type of Document: <br />Document Date: <br />Number of Pages: Signers) Other Than Named Above: <br />Capaotty(les) Claimed by Signer(s) <br />Signer's Name: <br />❑ Corporate Officer - Titles): <br />❑ Partner — ❑ Limited ❑ General <br />• Individual ❑ Attomey In Fact <br />• Trustee ❑ Guardian or Conservator <br />F1 Other: <br />Signer Is Representing: <br />Signer's Name: <br />• Corporate Officer — Title(s): <br />• Partner — ❑ Limited ❑ General <br />❑ Individual ❑ Attorney in Fact <br />❑ Trustee ❑ Guardian or Conservator <br />❑ Other: <br />Signer Is Representing: <br />. \.i+ \.5� ✓d.d �\..LSU .L. A..i "u4�J _ .h -. ti.4 vL\ ,. .5,.� ti 5 _ .i\�4' iao4 S�'! <br />0 1 • • •, r ate., • .if • 111: , •14j <br />23A -25 <br />
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