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23A - PROJ - SIDEWALK RENOVATIONS
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02/07/2017
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23A - PROJ - SIDEWALK RENOVATIONS
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Last modified
2/2/2017 3:35:22 PM
Creation date
2/2/2017 3:09:39 PM
Metadata
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
2/7/2017
Destruction Year
2022
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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 —orange } <br />On 12-6-16 before me, Claudia Cochran. Notary Public <br />ore reem name And title of e o car <br />personally appeared ----Ronnie Cochran - - a -• <br />who proved to me on the basis of satisfactory evidence to be the person(*whose <br />name(&.) is/ epee subscribed to the within instrument and acknowledged to me that <br />he/eHe�executed the same in his /her/th& authorized capacity4es), and that by <br />his /tlgeiw signature(&-) on the instrument the person(&}, or the entity upon behalf of <br />which the person(s) acted, executed the instrument. <br />certify under PENALTY OF PERJURY under the laws of the State of California that <br />the foregoing paragraph is true and correct <br />CLAUDIA CDCNRAN <br />r r' COMM # 2095962 <br />WITNESS m hand and official seal. , :lei ORANGE COUNTY <br />.- Y NOTARY PUBLIC•CALIFORNIAZ <br />- D MYCOMMISSIONEXPIRES <br />/ <br />Notaaryy u WSIgnature (Notary Public Seal) <br />ADDITIONAL OPTIONAL INFORI <br />DESCRIPTION OF THE ATTACHED DOCUMENT <br />(Title or description of attached document) <br />of Pages ____, Document Date <br />CAPACITY CLAIMED BY THE SIGNER <br />0 Individual (s) <br />0 Corporate Officer <br />(Title) <br />0 Partner(s) <br />0 Attorney -in -Fact <br />0 Trustee(s) <br />0 Other <br />INSTRUCTIONS FOR COMPLETING THIS FORM <br />This form complies with currmn California staaazs regarding rotary wording and, <br />ifneeded, should be nanyleterd and attached to the document Acknowledgments <br />fFnm other serles rimy be completed fin- documents being sent to thtd state so long <br />as the wording does not require the California notary to violate California notary <br />law. <br />• State and County information must be the State and County where the document <br />signer(s) personally Appealed before the notary public for acknowledgment. <br />• Date of real imflorr must be the date that the signers) personally appeared which <br />must also be die snow data 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 comnm and then your title (notary public), <br />• Print tine name(s) of document signcr(s) who personally appear at the tittle of <br />notarbodion. <br />• Indicate We correct singular or plural forms by crossing off incorrect forms (i.e. <br />heishe/they, -is tare lot cireliug doe correct forms. Failure to cmnectly indicate this <br />information may lead to rejection of document recording. <br />• The notary seal impression nntst be clear and photographically reproducible. <br />Impression must not cover text or lines. If seal impression smudges, re -seal if a <br />sufficient area permits, otherwise complete a different acknowledgment form. <br />• Siguourc of the notary public must match the signature on file with the office; of <br />the county clerk. <br />•o Additional information is not required but could help to ensure this <br />acknowledgment is snot nnisused or attached to a different document. <br />Indicate title or type ofatmehod document, number of pages and date. <br />Indicate the capacity claimed by the signer. If the claimed capacity is a <br />corporate officer, indicate the title (Le. CLO, CFO, Secretary). <br />• Securely attach this document to the signed document with a staple. <br />
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