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23A - PROJ - 3RD ST PAVING
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05/17/2016
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23A - PROJ - 3RD ST PAVING
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Last modified
5/12/2016 11:34:28 AM
Creation date
5/13/2016 8:51:11 AM
Metadata
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
5/17/2016
Destruction Year
2021
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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 drat document. <br />State of Cafifomia } <br />County of Los Angeles ) <br />On APP 1 1 (JIR before me, C. Phillips, Notary Public <br />Date Here Insert Name and Title of the Officer <br />personally appeared C. P. Brown <br />Names) of Signs*) <br />who proved to me on the basis of satisfactory evidence- to be the person(s) whose name(s) Is/am <br />subscribed to the within instrument and acknowledged to me that he /shay executed the same In <br />Itls,0MMtlte)r authorised capacity(les), and that by hist1libiftwir signature(s) on the instrument the person(s), <br />or the entity,upon behalf of which the person(s) acted, executed the instrument. <br />A� nyfomm Exniws QCL 29.201611 <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 />Signature 1 <br />Signat of Notary Public <br />Place Notary Seat 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 />Capactty(ies) Claimed by Signer(s) <br />Signer's Name: <br />❑ Corporate Officer — Title(s): <br />❑ Partner — ❑ Limited 0 General <br />❑ Individual ❑ Attorney in Fact <br />❑ Trustee ❑ Guardian or Conservator <br />M Other: <br />Signor Is Representing: <br />Signer's Name: <br />• Corporate Officer — Tille(s): <br />• Partner — ❑ Limited ❑ General <br />• Individual ❑ Attorney in Fact <br />• Trustee ❑ Guardian or Conservator <br />0 Other: <br />Signer Is Representing: <br />...4« ... �e�.nvy � �epq l 5 . �h�.1�y v /�;iy('!' , w+' l -rK1fi: r(35.: u4� ✓ <wSeFW aG�.n':c?:iC <br />23A -10 <br />
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