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AgdaPkt 2018-09-10 Joint SA PFA
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AgdaPkt 2018-09-10 Joint SA PFA
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Last modified
9/11/2018 8:39:31 AM
Creation date
9/6/2018 5:49:59 PM
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Template:
CC Index
CC Index - Document Type
Agenda Packet
Date
9/10/2018
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6.2.A. - Page 26 <br />STATE Or Colorado <br />SS. <br />COUNTY OF Denver <br />On July 29 2015 . , before me, <br />PERSOI•(ALLY APPEARED Justin Tomlin <br />personally known to me (or proved to rise ors the basis of <br />satisfactory evidence) to be the person(s) whose narne(s) Is/are <br />subscribed to the within instrument and acknowledged to me <br />thA he/site/they executed thg same in hWber/their authorized <br />capacity(les), and that by Ills/her/their signature(S) on the <br />Uistrusnent the person(s), or the entity upon behalf of which <br />persons) acted, executed the Instrument. <br />WITNESS my Band and official seal. <br />J �✓ <br />OPTIONAL <br />Yeren A. FeRzestad <br />KAREN A FEGG STA® <br />NOTARY PUBLIC <br />STATE OF COLORADO <br />i Notary ID 19934019078 <br />fitly CommInIon ergs 12129gq!7 <br />This area for Official Notarial Seat <br />Though the data below is :lot required by law, it may prove valuable to persons relying on the document and could <br />prevent fraudulent reattachment of this form. <br />CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED 00CUUENT <br />❑ INDIVIDUAL <br />❑ CORPORATE OFFICER <br />TITLE OF TYKE OF DOCUMENT <br />TITLEtS] <br />❑ PARTNER(S) ❑ LIMITED <br />❑ GENERAL. <br />lX ATTORNEY-IN-FACT <br />❑ TRUSTEE(() <br />❑ GUARDIAN/CON5ERVATOFt <br />Q OTHER; <br />SIGNER IS REPRESENTING; <br />NAM@ OF PEW3NIS] OR ENTITWES] <br />Allegheny Casualty Company <br />NUMBER OF PAGES <br />DATE= OF DOCUMENT <br />SIGNFR(S) OTHER THAN NAMED ABOVE <br />Io.©81. Rev,,6154 A U. -PT ?TR'POSF ACKNOWLEDGEMENT <br />
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