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23C - PROJ - STREET SLURRY SEAL
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07/07/2015
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23C - PROJ - STREET SLURRY SEAL
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Last modified
7/6/2015 8:40:47 AM
Creation date
7/2/2015 4:11:38 PM
Metadata
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23C
Date
7/7/2015
Destruction Year
2020
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CALIFORNIA ALL - PURPOSE ACKNOWLEDGEMENT CIVIL CODE 4 1189 <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 certificate is attached. and not the uvthfulness. accuracy, or validitv of that document <br />State of California <br />County of Riverside <br />On ;Tune 1, 2015 before me, B. Rooster, Notary Public <br />Date Here Insert name and Title of the Omcer <br />personally appeared Edward J. Carlson <br />Name�pors5gner(�° <br />who proved to me on the basis of satisfactory evidence to be the <br />persons) whose name(f) is /are subscribed to the within instrument <br />S. ROYSTER and acknowledged to me that he(shekhey executed the same In <br />Commission # 2083832 his /tterltheir authorized capaolty(les), and that by his /henkhelr <br />z :"'^� - Notary Public- California z signature(a) on the instrument the person(s), or the entity upon behalf <br />q Rlversltle County of which the person(r) acted, executed the instrument. <br />}� M Comm. Ex Ires Oct 26, 201a <br />I certify under PENALTY OF PERJURY under the laws of the State of <br />California that the forgoing paragraph is true and correct. <br />WITNESS my hpnd anA official seal <br />Signature 4,1. <br />Piece Notary seal Above sign ere of Notary Public <br />OPTIONAL <br />Though the information below is not required by law, if may prove valuable to person relying on the document <br />and could prevent fraudulent removal and reattachment of this form to another document. <br />Description of Attached Document <br />Title or Type of Document Bid Bond —City of Santa Ana <br />Document Date: June 1 2015 Number of Pages: 3 <br />Signer(s) Other Than Named Above:. Rebecca Haas - Bates, Attorney -In -Fact <br />Capacity(les) Claimed by Signer(s) <br />Signer's Name: Edward J. Carlson <br />❑ Individual <br />X Corporate Officer — Title(s): <br />„ Vice President <br />❑ Partner ❑ n Limited o General <br />❑ Attorney in Fact <br />❑ Trustee <br />Tap of Thumb here <br />n Other: <br />Signer is Representing: <br />Signer's Name: <br />❑ Individual <br />❑ Corporate Officer— Title(s): <br />• Partner ❑ ❑ Limited ❑ G�esnE <br />• Attorney in Fact j <br />• Trustee <br />❑ Other: i <br />Signer is Representing: <br />23C -21 <br />
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