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23A - PROJ - TRAFFIC SIGNAGE
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04/04/2017
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23A - PROJ - TRAFFIC SIGNAGE
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Last modified
3/30/2017 6:03:03 PM
Creation date
3/30/2017 5:32:07 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23A
Date
4/4/2017
Destruction Year
2022
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I...--,--------,--.-.--.--------,–.—.1 - -----_------- <br />CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT <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 <br />not the truthfulness, accuracy, or validity of that document. <br />STATE OF CALIFORNIA <br />County of Orange <br />On February 2nd, 2017 before me, Susan <br />Pugh Notary Public, <br />Date <br />Insert Name of Notary exactly as It appears on the official seal <br />personally appeared Shaunna Rozelle Ostrom <br />Name(s) of SIgner(s) <br />who proved to me on the basis of satisfactory evidence to <br />be the person(s) whose name(s) is/are subscribed to the <br />within instrument and acknowledged to me that he/she/they <br />executed the same in his/her/their authorized capacity(les), <br />and that by hls/her/their signature(s) on the Instrument the <br />person(s), or the entity upon behalf of which the person(s) <br />acted, executed the instrument. <br />I certify under PENALTY OF PERJURY under the laws of <br />the State of California that the foregoing paragraph is true <br />and correct. <br />Witness my hand and official seal. <br />Signature _,Z�q_181J �__, <br />Place Notary Seal Above <br />S19nature of Notary Public q San Pugh <br />OPTIONAL <br />Though the information below is not required by law, it may prove valuable to persons relying on the document <br />and could prevent fraudulent removal and reattachment of the form to another document. <br />Description of Attached Document <br />Title or Type of Document: Bid Bond <br />Document Date: 02/02/2017 <br />Number of Pages: One <br />Signer(s) Other Than Named Above: <br />Capacity(les) Claimed by Signer(s) <br />Signer's Name: Shaunna Rozelle Ostrom <br />Signer's Name: <br />❑ Individual <br />❑ Individual <br />❑ Corporate Officer — Title(s):_ <br />❑ Corporate Officer —Title(s): <br />❑ Partner ❑ Limited ❑ General <br />❑ Partner ❑ Limited ❑ General <br />Attorney in Fact <br />❑ Attorney In Fact I M 1 111] IT11 1.1 N :4 1 HE <br />❑ Trustee • <br />❑ Trustee • <br />❑ Guardian or Conservator Top of thumb here [:] Guardian or Conservator Top of thumb here <br />❑ Other: <br />❑ Other <br />Signer is Representing: <br />Signer is Representing: <br />..... . .... . ------ _J <br />1 JA-lb <br />
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