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23A - PROJ - PAVEMENT MAINTENANCE
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01/17/2017
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23A - PROJ - PAVEMENT MAINTENANCE
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Last modified
1/12/2017 3:57:50 PM
Creation date
1/12/2017 2:49:45 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
1/17/2017
Destruction Year
2022
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CALIFORNIA JURAT GOV CODE § 8202 <br />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 Riverside <br />REnECCA ANGELA PARKA <br />t m7 Commission N 2024344 <br />a e s' Notary Publiq C,sli:ornia <br />� >` >�' Riverside County <br />^"Pr =' My Comm. Expires Me 17, 2017 <br />Subscribed and sworn to (or affirmed) before <br />me on this 7 I day of December, 2016. <br />Date Month <br />By (1) Edward J. Carlson <br />Name of Signer <br />Proved to me on the basis of satisfactory evidence <br />be the person who appeared before me (.) (,) <br />M <br />Name- ofvigaer <br />enFe <br />be the peFsaR sre'me.) <br />Signature � �- z �2 <br />Place Notary Seal Above SlgnatL& of Notary Public <br />- -- OPTIONAL -- — <br />Though the Information below is not required by law, it may prove <br />valuable to person relying on the document and could prevent <br />fraudulent removal and reattachment of this form to another document. <br />Further Description of Any Attached Document <br />Title or Type of Document Non - Collusion Affidavit <br />Document Date: None Number of Pages: 7 <br />Signer(s) Other Than Named Above: None <br />Top of thumb here <br />23A -33 <br />Top of thumb here <br />
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