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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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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 Orange____ <br />On- September 16, 2016 before me Robyn R Kargari Notary Public, <br />._--_..___ ._..._..--------- _........ tyas rt ...._._ <br />Llafa. InsFr� NuenN oP i lolary oxaciYy as �F.ear., xi the o(N 7,ii seal - <br />personallyappeared TeratiJohnston <br />N mu jot $iynerlsl <br />�! 1'Mj RCwYN (}i 1 ° 21152 i <br />F` IR <br />J�L.CA. FUftNIh " <br />ORANGE <br />COUNTY <br />i'i ftmo tnPIV I:S 2019 <br />Pl,ce I d.,y ^until Above <br />who proved to me on the basis of satisfactory evidence to <br />be the persons) whose names) is/are subscribed to the <br />within instrument and acknowledged to me that he/she/they <br />executed the same in his/hedthelr authorized caparity(Ies), <br />and that by his/her/their signnture(s) on the instrument the <br />person(s), or the entity upon behalf of which the persons) <br />acted, executed the instrument. <br />I certify under PENALTY OF PERJURY under the laws of <br />the State of California that the foregoing paragraph is true <br />and correct. <br />Witness my he nd official sea <br />Signa 1-2 �" <br />wKa <br />��i,re Nolory Publtr; Robyn R. Kargan <br />Though the information below is not required by law, it may prove valuable to persons relying on the document <br />and could prevent fraudulent removal and reattachment of the form to another document. <br />Description of Attached Document <br />Title or'fype of Document: Bid Bond <br />Document Date: _Stember 1, 62016Number of Pages: -1— <br />Signer(s) Other Than Named Above: <br />Capecity(ies) Claimed by Signer(s) <br />Signer's Name Tereh Johnston _ <br />[) Individual <br />❑ co, pet ate officer...._...Title(s):.._..._ <br />F1 Partner (Limited ❑General <br />[V�j Attorney in Fact <br />n Trustee <br />Guardian cr Conservator <br />Other. <br />Signer is Representing: <br />Allie_d_ftrld Insunaue--......_._...._.._ <br />_ounAaIly..__. ._............. _....-.. <br />Signer's Name. _ <br />❑ Individual <br />❑ Corporate Officer--Title(s)', _ <br />❑ Partner C! Limited i-] General <br />❑ Attorney in Fact <br />❑ Trustee <br />❑ Guardian or Conservator <br />❑ Other: <br />Signer is Representing: <br />23A-24 <br />
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