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CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE § 8202 <br />- a�S <br />gSee Attached Document (Notary to cross out lines 1-6 below) <br />❑ See Statement Below (Lines 1-6 to be completed only by document slgner[s], not Notary) <br />Signature of Document Signer No. 1 Signature of Document Signer No. 2 (it any) <br />A notary public or other officer completing this certificate verifles only the Identity of the Individual who signed the <br />document to which this certificate Is attached, and not the truthfulness, accuracy, or validity of that document. <br />State of California <br />County of Q(_`P e <br />Subscribed and sworn to (or affirmed) before me <br />on this <br />day of —Ae(r , 20 I <br />by <br />Date Month Year <br />\ <br />(and (2) <br />), <br />Name(s) of Signer(s) <br />proved to me on the basis of satisfactory evidence <br />SIARNOZ -~� NATHANLOPEZ to be the person(s) who appeared before me. <br />+ Cammisslan # 2128413 <br />$ `ds Notary Public • California <br />Orange County Signature <br />My Comm. Ex Ires Se 2p 8, 201 g Signature of Notary'P eo <br />Seal <br />Place Notary Seal Above <br />OPTIONAL <br />Though this section is optional, completing this Information can deter alteration of the document or <br />fraudulent reattachment of this form to an unintended document. <br />Description of Attached Document Al.,N <br />Title or Type of Document: -rri�w5idn /-% (cb 04' Document Date: 411105-6"Y7 <br />Number of Pages: __L Signer(s) Other Than Named Above: <br />:ca:xaxx:��c:csusvgvevsr�cs;.c�,�u�.s�;�r,gcccssw:c¢aco�c�.�:�c.�ecw�ca <br />©2014 National Notary Association • www.NatlonalNotary.org - 1 -800 -US NOTARY (1-800-876-6827) Item 65010 <br />Walnut Pump Station and San lorenm Sewage Lift Station I City of Santa Are 24 <br />251-19 <br />