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Agmt04 Western Allied Mechanica
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Agmt04 Western Allied Mechanica
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Entry Properties
Last modified
7/21/2005 12:24:38 PM
Creation date
9/21/2004 8:29:21 AM
Metadata
Fields
Template:
Agreement
Contractor Name
Western Allied Mechanical
PROJECT NAME
air handler cooling coil replacement
RMP File Number
304
MO Ref
04-84 04-165
Box
5941
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<br />CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT <br /> <br />State of <br /> <br />CALIFORNIA <br /> <br />County of <br /> <br />LOS ANGELES <br /> <br />On <br /> <br />May 19, 2004 <br /> <br />before me, <br /> <br />NANCY M. CHAVEZ, NOTARY PUBLIC <br />Name and Title of Officer (e,g" "Jane Doe, Notary Public') <br /> <br />personally appeared <br /> <br />Gary Ditfurth <br /> <br />Name(s) of Signer(s) <br />proved to me on the basis of satisfactory evidence to be the person(s) whose <br />name(s) is/are subscribed to the within instrument and <br />acknowledged to me that he/she/they executed the same in <br />his/her/their authorized capacity(ies) , and that by his/her/their <br />signature(s) on the instrument the person(s) , or the entity upon <br />behalf of which the person(s) acted, executed the instrument. <br /> <br />~ personally known to me -OR- 0 <br /> <br />'e'. NANCY M. CHAVEZ I <br />..r " . COMM. #1408269 ..r <br />t> NOTARY PUBLIC. CALIFORNIA t <br />CQ LOS ANGELES COUNTY f WITNESS my hand and official seal. <br />C MyComm.ExpiresMar.30,2007 ,~, L/11 é~ <br />'tJ;J¿f ,¡ , <br />\ Signature of Nð' <br /> <br /> <br />---------------------------------------- 0 PTI 0 N A L --~-------------------------------------- <br /> <br />Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and <br />reattachment of this form to another document. <br /> <br />Description of Attached Document <br /> <br />Title or Type of Document: <br /> <br />Payment bond for Western Allied Mechanical, Inc. - Bond # 104330277 <br /> <br />Document Date: <br /> <br />May 19, 2004 <br /> <br />Number of Pages: <br /> <br />2 <br /> <br />Signer(s) Other Than Named Above: <br /> <br />Capacity(ies) Claimed by Signer(s) <br /> <br />Signer's Name: <br /> <br />Signer's Name: <br /> <br />Top of Thumb here <br /> <br />0 Individual <br />0 Corporate Officer <br />0 Title(s): <br />0 Partner - 0 Limited 0 General <br />0 Attorney-in-Fact <br />0 Trustee <br />0 Guardian or Conservator <br />0 Other: <br /> <br />RIGHT THUMBPRINT <br />OF SIGNER <br /> <br />0 Individual <br />0 Corporate Officer <br />0 Titles(s): <br />0 Partner - 0 Limited 0 General <br />0 Attorney-in-Fact <br />0 Trustee <br />0 Guardian or Conservator <br />0 Other: <br /> <br />RIGHT THUMBPRINT <br />OF SIGNER <br /> <br />Top of Thumb here <br /> <br />Signer Is Representing: <br /> <br />Signer Is Representing: <br /> <br />BO.1133 09/00 <br /> <br />-- T <br />
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