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EXCEL PAVING COMPANY
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Last modified
1/23/2024 3:28:52 PM
Creation date
1/12/2017 12:24:27 PM
Metadata
Fields
Template:
Contracts
Company Name
EXCEL PAVING COMPANY
Contract #
15-6848
Agency
Public Works
Council Approval Date
11/15/2016
Destruction Year
2021
Notes
PROJECT
Document Relationships
23B - PROJ - BICYCLE BLVDS
(Amends)
Path:
\Agenda Packets / Staff Reports\City Council (2004 - Present)\2016\11/15/2016
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CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT <br />A notary public or other officer completing this certificate verifies only the identity of the individual who signed die document to <br />which this certificate is attached, and not the truthfulness, accuracy, or validity of that document <br />State of California <br />County of Los Angeles <br />On I `A, w— before me, A. Henderson, Notary Public Notary Public, <br />(Here insert name and fitle of the officer) <br />personally appeared C. P. Brown <br />who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/ax subscribed to <br />the within instrument and acknowledged to me that he/sX/they executed the same in his/h*tlkr authorized <br />capacity(ies), and that by his/h)4/tlXr signature(s) on the instrument the person(s), or the entity upon behalf of <br />which the person(s) acted, executed the instrument. <br />I certify under PENALTY OF PERI JRY under the laws of the State of California that the foregoing paragraph <br />is true and correct. <br />WITNESS my hand and official seal. <br />A. A60&"" i <br />ignature of Notary Public <br />ADDITIONAL OPTIONAL INFORMATION <br />DESCRIPTION OF THE ATTACHED DOCUMENT <br />(Title or description of attached document) <br />(Title or description of attached document continued) <br />Number of Pages _ Document Date <br />(Additional information) <br />CAPACITY CLAIMED BY THE SIGNER <br />1] Individual (s) <br />0 Corporate Officer <br />(Title) <br />❑ Partner(s) <br />Attorney -in -Fact <br />® Trustee(s) <br />❑ Other <br />INSTRUCTIONS FOR COMPLETING THIS FORM <br />Any acknowledgment completed in California must contain verbiage exactly as <br />appears above in the notary section or a separate acknowledgment form must be <br />properly completed and attached to that document. The only exception is if a <br />document is to be recorded outside of California. In such instances, any alternative <br />acknowledgment verbiage as may be printed on such a document so long as the <br />verbiage does not require the notary to do something that is illegal for a notary in <br />California (i.e. certifying the authorized capacity of the signer). Please check the <br />document carefully for proper notarial wording and attach this form if required. <br />• State and County information must be the State and County where the document <br />signer(s) personally appeared before the notary public for acknowledgment. <br />• Date of notarization must be the date that the signers) personally appeared which <br />must also be the same date the acknowledgment is completed. <br />• The notary public must print his or her name as it appears within his or her <br />commission followed by a comma and then yaw title (notary public). <br />• Print the name(s) of document signers) who personally appear at the time of <br />notarization. <br />• Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. <br />he/she/they;- is /ere ) or circling the correct forms. Failure to correctly indicate this <br />information may lead to rejection of document recording. <br />• The notary seal impression must be clew and photographically reproducible. <br />Impression must not cover text or lines. If seal impression smudges, me seal. if a <br />sufficient area permits, otherwise complete a different acknowledgment form. <br />• Signature of the notary public must match the signature on file with the office of <br />the county clerk. <br />Additional information is not required but could help to ensure this <br />acknowledgment is not misused or attached to a different document. <br />Indicate title or type of attached document, number of pages and date. <br />Y 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 />• Securely attach this document to the signed document <br />..�uv, evn rsuwuc mbmmgaeru u, me. -m mgms xe.." www:ihdroLl k.coni- Nationwide Nota�SeMce <br />A.HENOERSON <br />COMM. ii2170176Notary <br />%my <br />Public -California <br />LOS ANGELES COUNTY a <br />Comm. Expires Oct 31, 2020 <br />(Notary Seal) <br />ADDITIONAL OPTIONAL INFORMATION <br />DESCRIPTION OF THE ATTACHED DOCUMENT <br />(Title or description of attached document) <br />(Title or description of attached document continued) <br />Number of Pages _ Document Date <br />(Additional information) <br />CAPACITY CLAIMED BY THE SIGNER <br />1] Individual (s) <br />0 Corporate Officer <br />(Title) <br />❑ Partner(s) <br />Attorney -in -Fact <br />® Trustee(s) <br />❑ Other <br />INSTRUCTIONS FOR COMPLETING THIS FORM <br />Any acknowledgment completed in California must contain verbiage exactly as <br />appears above in the notary section or a separate acknowledgment form must be <br />properly completed and attached to that document. The only exception is if a <br />document is to be recorded outside of California. In such instances, any alternative <br />acknowledgment verbiage as may be printed on such a document so long as the <br />verbiage does not require the notary to do something that is illegal for a notary in <br />California (i.e. certifying the authorized capacity of the signer). Please check the <br />document carefully for proper notarial wording and attach this form if required. <br />• State and County information must be the State and County where the document <br />signer(s) personally appeared before the notary public for acknowledgment. <br />• Date of notarization must be the date that the signers) personally appeared which <br />must also be the same date the acknowledgment is completed. <br />• The notary public must print his or her name as it appears within his or her <br />commission followed by a comma and then yaw title (notary public). <br />• Print the name(s) of document signers) who personally appear at the time of <br />notarization. <br />• Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. <br />he/she/they;- is /ere ) or circling the correct forms. Failure to correctly indicate this <br />information may lead to rejection of document recording. <br />• The notary seal impression must be clew and photographically reproducible. <br />Impression must not cover text or lines. If seal impression smudges, me seal. if a <br />sufficient area permits, otherwise complete a different acknowledgment form. <br />• Signature of the notary public must match the signature on file with the office of <br />the county clerk. <br />Additional information is not required but could help to ensure this <br />acknowledgment is not misused or attached to a different document. <br />Indicate title or type of attached document, number of pages and date. <br />Y 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 />• Securely attach this document to the signed document <br />..�uv, evn rsuwuc mbmmgaeru u, me. -m mgms xe.." www:ihdroLl k.coni- Nationwide Nota�SeMce <br />
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