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23A - PROJ - CENTENNIAL NEIGHBORHOOD WATER MAIN
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05/03/2016
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23A - PROJ - CENTENNIAL NEIGHBORHOOD WATER MAIN
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Last modified
5/23/2019 2:18:52 PM
Creation date
4/28/2016 2:23:17 PM
Metadata
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
5/3/2016
Destruction Year
2021
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT <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 San Bernardino <br />On February 10, 2016 before <br />personally appeared Pamela McCarthy <br />of Signer(s) <br />who proved to me on the basis of satisfactory evidence <br />to be the person whose name is subscribed to the <br />within instrument and acknowledged to me that she <br />executed the same in her authorized capacity, <br />and that by her signature on the instrument the <br />person, or the entity upon behalf of which the person <br />acted, executed the instrument. <br />e _ _ I certify under PENALTY OF PERJURY under the laws of <br />& °""UCit< ' the State of California that the foregoing paragraph is <br />LAIJRIE 8. DIiUCi( <br />rya;' Commisalon 16 1g02J12 true and correct. <br />a(f Notary public - OalNnrnla z <br />San Bernardino County " WITNESS my hand and official seal. <br />A4y Gomm. Expires Jul 14, 20'I fi <br />�e.r�v�•..y-wear'^�,,..a^ww:.�,..�--=•,tea <br />Signature of Notary Public <br />OPTIONAL <br />Though the information below is not required by law, It may prove valuable to persons relying on the document and could prevent fraudulent <br />removal and reattachment of this form to another document. <br />Description of Attached Document <br />Title or Type of Document: <br />Document Date: Number of Pages: <br />Signer(s) Other Than Named Above: <br />Capacity(ies) Claimed by Signer(s) <br />Signer's Name: <br />❑ Individual <br />❑ Corporate Officer <br />Title <br />❑ Partner -- ❑ Limited ❑ General <br />❑ Attorney -in -Fact <br />❑ Trustee <br />❑ Guardian or Conservator <br />Other: <br />Signer is Representing: <br />Top of thumb here <br />23A-14 <br />
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