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Last modified
10/22/2015 2:52:38 PM
Creation date
10/22/2015 1:46:34 PM
Metadata
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Template:
Contracts
Company Name
VA CONSULTING
Contract #
A-2015-174
Agency
PUBLIC WORKS
Council Approval Date
8/4/2015
Expiration Date
8/4/2019
Insurance Exp Date
11/24/2015
Destruction Year
2024
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LJ <br />0 <br />CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE § 8202 <br />ICJ See Attached Document (Notary to cross out lines 1 -6 below) <br />❑ See Statement Below (Lines 1 -6 to be completed only by document slgner[s], not Notary) <br />3rgnahrre -offJoevmenfSigrvei-Pdo.7 -^ sigrratvre- of- Bocurnetrt- 9ignarNo- c'-(ff-anY) <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 4, 2 <br />a , VERA AUGUSTA KLATCH <br />Commission # 20152616 <br />Notary Public • California z <br />orange County <br />M Comm Es Iras MIT 26 2017+ <br />Seal <br />Place Notary Seal Above <br />Subscribed and swerpr to (or affirmed) before me <br />on this —LB�L day of ALA- 1 20 P <br />by Date Month Year <br />Name(s) of Signer(s) <br />proved to me on the basis of satisfactory evidence <br />to be the person who appeared before me. <br />Signature - <br />Signature o otary Public <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 />Number of Pages: ----- Signer(s) Other Than Named Above: <br />Document Date: <br />02014 National Notary Association • www.NationaiNotary.org - 1- 800 -US NOTARY (1- 800 -676 -6827) Item #5910 <br />
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