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MYERS AND SONS HI-WAY SAFETY, INC
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MYERS AND SONS HI-WAY SAFETY, INC
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Last modified
1/8/2018 4:15:59 PM
Creation date
7/17/2017 3:08:31 PM
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Contracts
Company Name
MYERS AND SONS HI-WAY SAFETY, INC
Contract #
15-6833
Agency
Public Works
Council Approval Date
4/4/2017
Insurance Exp Date
9/10/2020
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CALIFORNIA ALL-PURPOSE <br />CERTIFICA'T'E OF ACKNOWLEDGMENT <br />State of California <br />County of San Bernardino <br />On February 6, 2017 before me, Barbara E. Paluzzi, Notary Public <br />(Here insert time and title of the officer) <br />personally appeared Mike Rodgers, President <br />who proved to me on the basis of satisfactory evidence to be the person(s) whose name se subscribed to <br />the within instrument and acknowledged to me that091-e4ey executed the same inIs srUeii authorized <br />capacity(ies)and that by is signature(a) on the instrtnnent the person( -s-), or the entity upon behalf of <br />which the person(s) acted, executed the instrument. <br />I certify tinder PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph <br />is true and correct. <br />IT�SS y ha q1t <br />al <br />Si afNotary Public (Notary Seal) <br />A..... Z BA <br />RBAgA E. PALUZI <br />a COMM. # 2136060 ...+ <br />NOTARY PUBLIC -CALIFORNIA(' <br />BAN BEkNAROINO GOUN7V0 <br />My 06mmisslon Bxjehma <br />DBpemOmT d3,.$g18 <br />ADDITIONAL OPTIONAL INFORMATION <br />DESCRIPTION OF THE ATTACHED DOCUMENT <br />(Title or description of attached document) <br />Title or description continued <br />(Title or description of attached document continued) <br />Number of Pages _ Document Date 4/22/15 <br />(Additional information) <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 />Id information checked <br />2008Version CAPAvl2.10.07R00-873-9865 www.NotaryClasses.com <br />INSTRUCTIONS FOR COMPLETING THIS FORM <br />Any acknowledgment completed in California most contain verbiage exactly as <br />appears above in the notary section or a separate acknowledgment form mist 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. oertifymg the authorized capacity of the signer). Please check the <br />document carefully for proper notarial wording and attach this immif required. <br />• State and County information must be the State and County where Do document <br />signers) personally appeared before the notary public for acknowledgment. <br />• Date of notarization 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 print his or her name as it appears within his or her <br />commission followed by a comma and then your title (notary public). <br />• print the names) of document signer(s) 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/thay,- is Ism) 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 test 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 camty 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 />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 dominant <br />
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