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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 />CERTIFICATE OF ACKNOWLEDGMENT <br />State of California <br />County of <br />San Bernardino <br />On February 6, 2017 <br />before me, Barbara E. Paluzzi, Notary Public <br />(Here insert name 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 Is subscribed to <br />the within instrument and acknowledged to me that Ghek executed the same in is, authorized <br />capacity(-i€s} and that by is � signature(&) on the instrument 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. BARBARA E. PALuzzl <br />COMM. # 2136088 u <br />V S �•o NOTARY PUBLIC •CALIPORNIc <br />H- �, SANBERNARD!NOCOUNTv i) <br />IT SS m hand and lal Seal. My Commission Expires <br />y DBGsmbel 23, 2019 <br />cy <br />mreofD otary ublic (Notary Seal) <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 Doctunent Date 4122/15 <br />(Additional information) <br />CAPACITY CLAIMED BY THE SIGNER <br />❑ <br />Individual (s) <br />❑ <br />Corporate Officer <br />(Title) <br />❑ <br />Partner(s) <br />- ❑ <br />Attorney -in -Fact <br />❑ <br />Tnlstee(s) <br />❑ <br />Other <br />Id information checked <br />2008 Version CAPAvl2.10.07800-873-9865 www.NotaryClasses.com <br />INSTRUCTIONS FOR COMPLETING THIS FORM <br />Any acknowledgment completed in California must contain verbiage exactly as <br />appears above in the notary section or a separate acknowledgment form must 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. cerd5mg the authorized capacity of the signer). Please check the <br />document carefully for proper notarial wording and attach this form if required. <br />• State and County information must be the State and County where the document <br />signer(s) 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 namc(s) 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/£bey- is /are) 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 fines. 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 />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 document <br />
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