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Last modified
7/7/2025 11:56:55 AM
Creation date
4/3/2017 12:48:05 PM
Metadata
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Template:
Contracts
Company Name
GOLDEN STATE CONSTRUCTOR
Contract #
16-2671
Agency
Public Works
Council Approval Date
2/7/2017
Expiration Date
11/3/2017
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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 -2-7 2 _ before me, _Claudia Cochran, Notary Public , <br />eretaert name an et attar <br />personally appeared --------------Ronnie Cochran -- — <br />who proved to me on the basis of satisfactory evidence to be the person(*whose <br />names) iskwe subscribed to the within instrument and acknowledged to me that <br />heey executed the same in his/herAheii: authorized capacity(-ies), and that by <br />his/*erAheff signature(s) on the instrument the person(s}, or the entity upon behalf of <br />which the person(6) acted, executed the instrument. <br />I certify under PENALTY OF PERJURY under the laws of the State of California that <br />the foregoing paragraph is true and correct. _ <br />GLADOIA COCHRAN <br />COMM # 2095862 <br />WITNESS my hand and official seal. . V4, ORANGE couNTv DA <br />_ NOTARY PUBLIC -CALIFORNIA z <br />MY COMMISSION EXPIRES -r <br />JAN. 30, 2019 <br />Notary Public Signature (Notary Public Seal) <br />OF THE ATTACHED DOCUMENT <br />(Title or description of attached <br />or description of <br />of Pages `Document Date <br />CAPACITY CLAIMED BY THE SIGNER <br />❑ Individual (s) <br />❑ Corporate Officer <br />(Title) <br />❑ Partner(s) <br />❑ Attorney -in -Fact <br />❑ Trustee(s) <br />❑ Other <br />INSTRUCTIONS FOR COMPLETING TIIIS FORM <br />This farm complies with current California statutes regarding notary wording and, <br />ifneedeel, should be completed and attached to the document. Acknowledgments <br />from other states may be completed for documents being sent to that state so long <br />as the wording does not require the California notary to violate California rotary <br />law. <br />• State and County information must be the State mrd County where the document <br />signor(s) personally appeared before the notary public for aclnowledgment. <br />• Date of notatizatlon must be the date that the signer(s) personally appeared which <br />must also be the same date the acknowledgment is completed. <br />• The notary public must poor his or her name as it appears within his or her <br />commission followed by a comma and then your title (notary public), <br />• Punt the names) of document signer(s) who personally appear at the time of <br />notarization. <br />• Indicate the comet singular or plural forms by crossing off incorrect forms (i.e. <br />be/she/they; is fere) 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 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 />• Signature of the notary public must match the signature on file with the office of <br />the county clerk. <br />•b Additional information is not required but could help to ensure this <br />acknowledgment is notmisused or attached to a different document. <br />Indicate title or type of attached 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 (i.e. CEO, CFO, Secretary). <br />• Securely attach this document to the signed document with a staple, <br />
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