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23A - PROJ - SAFE ROUTE KING ELEM
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10/18/2016
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23A - PROJ - SAFE ROUTE KING ELEM
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Last modified
10/13/2016 2:52:28 PM
Creation date
10/13/2016 2:48:59 PM
Metadata
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
10/18/2016
Destruction Year
2021
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ALL-PURPOSE ACK16'OWLEI)CMENT <br />State of C'alifot nia <br />Los Angeles -_ SS. <br />County of 6 <br />On October 10, 2016before me,lltem Chu Notary Public, <br />usrr <br />personally appealed Van Nguyen _ -- > who proved to me on the <br />taasis of saiisfiti:tory evidence to be the personW whose nuMCW islzXR subscribed to the within instrument <br />and acknowledged to me that he/&bwA)W executed the <br />same in hishlm�*asir authorized capacity(i(z), and that <br />by his/imixinvix signature(rt) on the instrument the <br />personb6, or (lie entity upon behalf of which the <br />( person(gA acted, executed the instrUelent. <br />I certifv under PE'vAUTY OF PERJURY under the <br />laws of the Mate of California that the foregoing <br />paragraph N true and correct. <br />ply ggg wvrNE:SS my hand and orilcial seal. <br />Uj ,� .. t� ao=Aavvusllc•cAurnal+ln �� <br />M, �' "' 108 A4AP!ES COUNIY <br />amw+v <br />W Comm Up Pap A A17 <br />NO"I:VKY'SSIGN.AI'URa <br />A notary public or other office completing this certificate verifies only the identity of the individual who signed the document <br />to which this certificate is attached, and not the truthfulness, aecuracv, or validity of that document. <br />PLAC[ NQCARY NI.AL IN AnOV L SW.ACG <br />mummmwmamommommmm OPTIONAL INFORMATION <br />ION <br />The informal ion below is optional. However, itmay prove Voluable and could preventflraudilent attachment <br />of this Form to out unauthorized (locu nem. <br />CAPACITY CLAIN'tEl)13Y SIGNER (PRINCIPAL) <br />NT <br />DESCRIPTION OFATTACPIEI) DOCUMENT <br />❑ <br />INDIVIDUAL <br />X <br />C:ORPORNIF OFFICER Presidenl,�"esratnry Sieasurar, <br />Manager 11 fLL{)itTl t fof DOCCN1fuT <br />[] <br />PAR'fNR:R(S) IF1LlxsI <br />-YI'TORNLY-IN-PAC:"I' <br />TRUSTLf (S) <br />Nl.iM73 LR 01 PAGES <br />[� <br />GUAR.UTANXONSFRVATOR <br />El <br />OlIIBR: <br />, oi,— _ <br />SIG NTR(PRIN( IPAL)ISREPRESENTING: <br />N9\7P OIPI.RS(XMti) Old I I I Y( II S) <br />California Professional Engineering, Inc. <br />RIGHT <br />"iNUMBPRINT <br />OP <br />S IUNf.R <br />OTHER <br />AMI'"''' Myl A10 MY, tri Sl PPLILS AND I ORM' U1111 `-ASWR'.VA lkYMTdtR%( OA 21W.1 2010b VAI_ I. J,YMI RR( IWIRANCI <br />23A-23 <br />
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