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25J - AGMT - BRISTOL ST PHASE 3A
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11/15/2016
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25J - AGMT - BRISTOL ST PHASE 3A
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Last modified
11/10/2016 4:35:48 PM
Creation date
11/10/2016 4:29:40 PM
Metadata
Fields
Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
25J
Date
11/15/2016
Destruction Year
2021
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CALIFORNIA ALL- PURPOSE <br />CERTIFICATE OF ACKNOWLEDGMENT <br />A notary public or other officer completing this certificate verifies only the identity <br />of the individual who signed the document to which this certificate is attached, <br />and not the truthfulness, accuracy, or validity of that document. <br />State of California <br />County of <br />d� <br />On C� �J: J before me, <br />�— are inv,0 name ant ItOe o(Inn oTj <br />personally appeared <br />who proved to me on the basis of satisfactory evidence to be the person—(,6) whose <br />name( Is/ r subscribed to the within instrument and acknowledged to me that <br />( e Atlee executed the same in his/her/their authorized capacity((es"), and that by <br />FIs their signature(sl on the instrument the person(5y), or the entity upon behalf of <br />which the person(s) acted, executed the instrument. <br />rtify under PP`C ALTY OF PERJURY under the laws of the State of California that <br />foregoing paragraph is true and correct. <br />NESS my h no and official al. p MA OUO2osoMA <br />r` <br />• It NOTARY PUBLIC - CAUFORNIA@I <br />ORANGE COUNTY 0 <br />r COMM. EXPIRES OCT. 3, 2018 -+ <br />ry Public Signat------`"-"- .,_— (Notary Public Seal) <br />Mu 1MM,M <br />OF THE ATTACHED DOCUMENT <br />IT ill or description of a(dached document) <br />(Title or descriphen of altncheddocument continued) <br />of Pages __ Document Date..-.__._ --- <br />CAPACITY <br />_ <br />CAPACITY CLAIMED BY THE SIGNER <br />Individual (s) <br />0 Corporate Officer <br />(Title) <br />0 Partner(s) <br />0 Attorney -in -Fact <br />0 Trustee(s) <br />Ottley <br />. _ , ,It t:4, . _ <br />INSTRUCTIONS FOR COMPLETING THIS FORM <br />Tho ivan cnnrp(irts wi(h torrent CnliJnrnla .rfanrtnetegarding rminry trawling and, <br />iJnacded, should Ga rouQ�lated earl attached to the tlnaunsen/. dclnlow(edgntertls <br />fi•mn other stoles may he ennytfatadJmdouumanGs hcing sear to shot strrlu.ro inrsq <br />as the no, does not require the Col polnin nmmy to violate Cal/fbrnla noltn y <br />Intr. <br />• State and County inforntntioll must be the State and County where the document <br />signet(s) personally appeared before the nouaypublic rot acknowledgment. <br />• Date of notarization must be the (lute that the signcr(S) personally appeared Which <br />must also be the sone date the acknowledgment is completed. <br />• Tu notary public oust print his or her inane as ii npFIMS within his or her <br />cotnnrissien followed by a comma and then youtitle (notary public). <br />• Print the name(s) of document signct(s) who personally appear at the tines of <br />nounimtion. <br />• redieatC the correct singular or ptutd forms by crossing off iocu'rcct flims (i.c. <br />be/sduhheyr is Ane ) or circling les correct t'arms. Failure to curcctly indicate this <br />information nlay lead to rejection of document recording. <br />• 'file nanny seal impression must be clear and photographically reproducible. <br />Impression must not cover teal or lines 11'seal impression snwdges, ro-sed if a <br />sill l iciest area permits, otherwise complete a different tick nowlcdgmcnt tin'ia <br />• Signature efthe nutaiy puhlic mast nhatch the signature on lite wide the oFice of <br />the county clerk. <br />Additional Imfomnnion is not required but could help W en5arc Itis <br />aclaloo-lodgment is mol misused or attached to a diflclent document. <br />Indicate title or type ornttached document, number oFpages and date. <br />Indicate the capacity claimed by the signer. If the claimed capacity is a <br />corporate officer, indicate the title (i.e. CEO, CFO, Secretary). <br />• Securtly attach this document to the signed documem With a staple. <br />25J-16 <br />
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