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EBS GENERAL ENGINEERING, INC.
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EBS GENERAL ENGINEERING, INC.
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Last modified
1/12/2017 4:47:33 PM
Creation date
12/13/2016 11:45:09 AM
Metadata
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Template:
Contracts
Company Name
EBS GENERAL ENGINEERING, INC.
Contract #
16-6854
Agency
Public Works
Council Approval Date
10/18/2016
Notes
PROJECT
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CALIFORNIA JURAT WITH AFFIANT STATEMENT <br />CLQ See Attached Document (Notary to cross out lines 1-6 below) <br />❑ See Statement Below (Lines 1-5 to be completed only by document signer[s], not Notary) <br />Signature of Document Signer No. 1 <br />State of California <br />County of _ORANGE <br />t_EXIE SHERWCCD <br />-a��, <br />COMM. 112031782 9 <br />-rH •d:'_-� NOTARYPS9LIC <br />.-CALIFORNIA <br />qo ORANGE COUNTY t <br />� Cofnm. Exp. JULY 27, 2017 <br />ti^vvv^vv`v'v"vv'w�v'v'^+^v^v^v"v'v' <br />Signature of Document Signer No. 2 (If any) <br />Subscribed and sworn to (or affirmed) before me on this <br />15TH day of SEPTEMBER , 20-16—, by <br />Date Month Year <br />(1) SPENCER FLAKE <br />Name of Signer <br />proved to me on the basis of satisfactory evidence <br />to be the person who appeared before me (.) (,) <br />(and <br />(2) <br />Name of Signer <br />proved to me on the basis of satisfactory evidence <br />to be the person wh appeared b fore me.) <br />Signature <br />Signature of Notary Public <br />Place Nolary Seat Above <br />OPTIONAL <br />Though the information below is not required by law, it may prove <br />valuable to persons relying on the document and could prevent <br />fraudulent removal and reattachment of this form to another document. <br />Further DescriptionofAny Attached Document <br />Tltte or Type of <br />Document Dale: <br />Signer(s) Other Than Named Above: <br />Number of Pages; <br />RIGHTTHUMBPRINT'. RIGHTTHUMBPRINT <br />OF SIGNER #1 OF SIGNER in <br />02007 National NotaryAssoclafion•gala De Soto Ave,, P.O. Dox 2402•Chaleworlh, CA 913132402, www.NaborwlNotaryorg aem#5910 Rfwrdor.Ca ITOII-Fmo1-8C68766827 <br />
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