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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
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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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GOV CODE <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 truthfulness, accuracy, or validity of that document. <br />State of California <br />County of Riverside <br />B. ROYSTER <br />Commission # 2083032 <br />i Notary Public - California zz <br />Riverside County <br />My Comm. Expires Oct 26, 2018 <br />Subscribed and sworn to (or affirmed) before <br />me on this 1St day of June 2015, <br />Date Month <br />By (1) Edward J. Carlson <br />Name of Signer <br />Proved to me on the basis of satisfactory evidence <br />be the person who appeared before me (.) (,) <br />(2) <br />(and <br />Name <br />Prove me on the basis of satisfactory evidence <br />be e person who appeared before me.) <br />Signature <br />Place Notary Seal Above Signatur 7f Notary Public <br />OPTIONAL <br />Though the information below is not required by law, it may prove <br />valuable to person relying on the document and could prevent <br />fraudulent removal and reattachment of this form to another document. <br />Further Description of Any Attached Document <br />Title or Type of Document Non - Collusion Affidavit <br />Document Date: 6 -1 -15 Number of Pages: 1 <br />Signer(s) Other Than Named Above: None <br />23C -28 <br />Tap of thumb here <br />
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