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PALP INC. DBA EXCEL PAVING COMPANY (2)
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PALP INC. DBA EXCEL PAVING COMPANY (2)
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Last modified
10/27/2016 1:55:50 PM
Creation date
10/5/2015 9:04:50 AM
Metadata
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Template:
Contracts
Company Name
PALP INC. DBA EXCEL PAVING COMPANY
Contract #
Various
Agency
Public Works
Council Approval Date
5/5/2015
Insurance Exp Date
6/1/2016
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT <br />CML CODE § 1188 <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 />Countyof Los Angeles ) <br />On MAS( 19 299 before me, C. Phillips, Notary Public <br />, <br />Date Here Insert Name and Title of the Officer <br />personally appeared C. P <br />Name(s) of Signer(s) <br />who proved to me on the basis of satisfactory evidence to be the person(* whose name(a) is/am <br />subscribed to the within instrument and acknowledged to me that he/ahafty executed the same in <br />his/mfbek authorized capacity(ies), and that by his/Heolth& signature(s) on the instrument the person(s), <br />or the entity upon 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 seal. <br />C PHILLIPS <br />COMM 0/996177 n <br />Notary Public. Calltornia a Signature <br />P - LOS ANGELES COUNTY a <br />JIM <br />y comm. Exnlies Ont. as, tots S gna ua of Notary Public <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: Signer(s) Other Than Named Above: <br />Capacfty(fes) Claimed by Signers) <br />Signer's Name: <br />❑ Corporate Officer - Title(s): <br />❑ Partner — ❑ Limited ❑ General <br />❑ Individual ❑ Attorney in Fact <br />❑ Trustee ❑ Guardian or Conservator <br />n 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 />
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