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THE SOURCE SANTA ANA, A MEDICAL & ADULT USE RETAIL CANNABIS BUSINESS - 2017
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THE SOURCE SANTA ANA, A MEDICAL & ADULT USE RETAIL CANNABIS BUSINESS - 2017
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Last modified
1/2/2018 10:09:33 AM
Creation date
1/2/2018 9:12:12 AM
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Contracts
Company Name
THE SOURCE SANTA ANA, A MEDICAL & ADULT USE RETAIL CANNABIS BUSINESS
Contract #
A-2017-369-07
Agency
PLANNING & BUILDING
Council Approval Date
11/9/2017
Expiration Date
12/31/2020
Destruction Year
2025
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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 �- - -�O`CLL' } <br />County of <br />On before me, L)\-Q�{J{' ��P I o h (\ t <br />� ® Qa� _ �(,- nsert-aame.an3Int�aotlisec� <br />personally appeared V' 'Ao'M <br />who proved to me on the basis of satisfactory evidence to be the person* whose <br />name( is/are subscribed to the within instrument and acknowledged to me that <br />he/sh4BA#e-yexecuted the same in his/he authorized capacity(ies), and that by <br />his/hgr-th4i it signature(s) on the instrument the person(s), or the entity upon behalf of <br />which the person(&) 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 />D. PERREZ� <br />WITNESS my hand and official seal. Commission No.2150948 # <br />Z <br />NOTARY PUBLIC -CALIFORNIA <br />IIT\\1CommLOS ANGELES COUNTY <br />4"'{� Z MY . Expires APRIL 28, 2020 <br />(Notary Public Seal) <br />I_H11111 [e] L, Ie1 iiiIii :Am [*I Ill a I c I7li#h1 /_% I <br />DESCRIPTION OF THE ATTACHED lNT <br />(Title or description of attached document) <br />(Title or description of attached document continued) <br />Number of Pages III— - Document Date ( 2_' 2-11 VI <br />CAPACITY CLAIMED BY THE SIGNER <br />❑ Individual (s) <br />,l Corporate Officer <br />(Title) <br />❑ Partner(s) <br />❑ Attorney -in -Fact <br />❑ Trustee(s) <br />❑ Other <br />2015 Version www.NotaryClasses.com 800-873-9865 <br />INSTRUCTIONS FOR COMPLETING THIS FORM <br />DN This form complies with current California statutes regarding notary wording and, <br />if needed, 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 notary <br />law. <br />N State and County information must be the Some, and County where the document <br />signer(s) personally appeared before the notary public for acknowledgment. <br />N 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 />N 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 />N Print the name(s) of document signer(s) who personally appear at the time of <br />notarization. <br />0 Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. <br />he/she/they,-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 lines. If seal impression smudges, re -seal if a <br />sufficient area permits, otherwise complete a different aclmowledgment form. <br />N Signature of the notary public must match the signature on file with the office of <br />the county cleric. <br />N Additional information is not required but could help to ensure this <br />acknowledgment is not misused or attached to a different document. <br />N 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 dee title (i.e. CEO, CFO, Secretary). <br />IN Securely attach this document to the signed document with a staple. <br />
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