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Agmt96 County of San Mateo
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Agmt96 County of San Mateo
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Last modified
7/5/2005 2:30:28 PM
Creation date
11/15/2004 11:47:56 AM
Metadata
Fields
Template:
Agreement
Contractor Name
County of San Mateo
PROJECT NAME
supplemental agreement No. 21 Emeral Lake Heights Sewer
RMP File Number
304
Date
9/9/1997
Reso Ref
12833
Box
5854
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<br />CALIFORNIA ALL.PURPOSE ACKNOWLEDGMENT <br />State of California } 55 <br />County of S G...<\ \'<\0-.. \ ~ 0 <br /> I <br /> -J o-..(). 2.CD! 199<ð, before me, L r\Qo...... L~-e.. G(~~ No\-o..r r'-Jb\<c ] <br />On <br /> Dale Name and Title of Officer (e.g., "Jane Doe, Notary Public") <br />personally appeared tv\ ~ LY\ 6..-L \ 1), ~-ev \ IIÎ. <br /> Name(s) of Signer(s) <br /> ~personally known to me <br /> D proved to me on the basis of satisfactory ] <br /> evidence I <br /> !~~~:~ " /ì1~~~ to be the person(~ whose name~are <br /> i",)( ",,\ Cc~nm. # 1067878 ~ subscribed to the within instrument and <br /> ? ~:\.. ~ NOTARY DUBUC CALIFORNIA J) acknowledged to me tha~he/they executed <br /> ~ " San Mateo County the same in ~/her/their authorized <br /> J~.~:~:"",,~~o~~~ capacity(i~), and that by @/her/their <br /> signature~ on the instrument the person(s), or <br /> ,!b.e entity upon behalf of which the person(~ <br /> acted, executed the instrument. <br /> WITNESS my hand and official seal. <br /> Place Notary Seal Above '--Ivtn ~g~ryp~ <br /> ] <br /> OPTIONAL I <br />Though the information below is not required by law, it may prove valuable to persons relying on the document <br /> and could prevent fraudulent removal and reattachment of this form to another document. <br />Description of Attached Document :tal A <br />Title or Type of Document:.su \! m <br /> tYY\.~,,-\ð.. Lo...\u. \.4 \<) <br />Document Date: q \ q \ q1 <br /> \ \ <br />Signer(s) Other Than Named Above: 3 <br />Capacity(ies) Claim~d by Signer <br />Signer's Name: H , c..h <Le.-I J) , Nev¡'ý\ RIGHT THUMBPRINT <br />D Individual OF SIGNER <br /> Top of thumb here I <br />D Corporate Officer - Title(s): I <br />D Partner - D Limited D General <br />D Attorney in Fact <br />D Trustee <br />D Guardian or Conservator <br />~ Other: ?(e..s', ò-tit+ , ?'>o(À.¡rJ. of SV(.l-VVI sor.5 <br /> , <br />Signer Is Representing: CO\J(1 of 50...("\ mct..+~ 0 o.-ncl <br /> Emv C:~,J ð-. Lo... e.. \-\e..l ~\t1+S 5 e IN -c.r M.IX.;I"\ +~ ntÀ.1"1 (-€- D,sf.Y ICt- <br />© 1997 National Notary Association· 9350 De Soto Ave., P.O. Box 2402· Chatsworth, CA 91313-2402 Prod. No. 5907 Reorder: Call Toll-Free 1-800-876-6827 <br /> ~...._.._-'-,.,.. ~.., "'--.-'.- <br />
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