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Agmt01 Western States Surfacing
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Agmt01 Western States Surfacing
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Last modified
7/21/2005 12:24:21 PM
Creation date
5/13/2002 9:59:25 AM
Metadata
Fields
Template:
Agreement
Contractor Name
Western States Surfacing
PROJECT NAME
Asphalt rubber chip seal project
RMP File Number
304
Date
6/25/2001
Reso Ref
14253
MO Ref
01-125
Box
5941
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<br />CALIFORNIA ALL.PURPOSE ~KNOWLEDGMENT <br /> <br />No. 5907 <br /> <br />State of California <br />County of Sacramento <br /> <br />On <br /> <br />June 11, 2001 <br />DATE <br /> <br />before me, <br /> <br />Nina Hall, Notary Publit <br />NAME, TITLE OF OFFICER. E.G.. 'JANE OOE. NOTARY PUBLIC. <br /> <br />personally appeared <br /> <br />Tina N. Handy <br /> <br />NAME(S) OF SIGNER(S) <br /> <br />[] personally known to me . OR . 0 proved to me on the basis of satißfactory evidence <br />to be the person(s) whose name(s) is/are <br />subscribed to the within instrument and ac- <br />knowledged to me that he/s~e/they executed <br />the same in his/her/th:eir authorized <br />capacity(ies), and that ~y his/her/their <br />signature(s) on the instrum~nt the person(s), <br />or the entity upon beha f of which the <br />person(s) acted, executed the instrument. <br /> <br /> <br />NINA HALL ~ <br />COMM. #1144948 CD <br />Notary Public-CaHfornie ~ <br />SACRAMENTO COUNTY- <br />MyComm.Exp.JuI.1,2001 ~ <br /> <br />WITNESS my hand and offici I seal. <br /> <br />~~ <br /> <br /> <br />SIGNATURE OF NOTA Y <br /> <br />Nina Hall <br /> <br />OPTIONAL <br /> <br />Though the data below is not required by law, it may prove valuable to persons relying on the doc ment and could prevent <br />fraudulent reattachment of this form. <br /> <br />CAPACITY CLAIMED BY SIGNER <br /> <br />0 INDIVIDUAL <br />0 CORPORATE OFFICER <br /> <br />DESCRIPTION OF ATT CHED DOCUMENT <br /> <br />0 PARTNER(S) <br /> <br />0 LIMITED <br />0 GENERAL <br /> <br />TITLE OR TYPE 01 DOCUMENT <br />I <br /> <br />TlTLE(S) <br /> <br />a ATTORNEY-iN-FACT <br />0 TRUSTEE(S) <br />0 GUARDIAN/CONSERVATOR <br />0 OTHER: <br /> <br />NUMBER 0 PAGES <br /> <br />DATE OF DO UMENT <br /> <br />SIGNER IS REPRESENTING: <br />NAME OF PERSON(S) OR ENTITY(IES) <br /> <br />National Fire Insurance Company of <br />Hartford <br /> <br />SIGNER(S) OTHER TH N NAMED ABOVE <br /> <br />~1993 NATIONAL NOTARY ASSOCIATION' 8236 Remmel Ave., P.O. Bo~ 7184' Canoga Park, CA 91309.7184 <br />
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