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RecD08 2008-025705
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RecD08 2008-025705
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Last modified
4/1/2008 11:51:11 AM
Creation date
4/1/2008 11:51:11 AM
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Fields
Template:
Agreement
Contractor Name
South Bayside System Authority
PROJECT NAME
Recycled Water Treatment/Storage/Pumping Facility Site
Date
3/11/2008
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<br />CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT <br />. <br /> <br />State of California <br />County of ~ /lJ;;TEC <br />On ~iI~ ~ ~CJbefore me, <br />ate D' d <br />personally appeared OM E""-'- <br /> <br />} <br /> <br />&..e-v.eL- <br /> <br />z. /Jk.€~#6'H dm~ 4.uv' <br />Here Insert Name and Tille of1he Officer <br /> <br />Name(s) of Signer(s) <br /> <br />J'- ---:: ~~ - - - - f <br />_. ~~:* '967 . <br />I ---"-"" f <br />Ian uae.o Ccu1Iv - <br />MrCclmm.....AUg21. <br />~-~~~-_~~4.__~ <br /> <br />who proved to. m.! on the basis of ~isfactory evidence to <br />be the person~ whose name~~re subscribed to the <br />~in instrument and acknow~ed to me that <br />~he/they executed the " i~her/their authorized <br />capacity~, and that bY~her/their signature~ on the <br />instrument the per70n;i), or the entity upon behalf of <br />which the person~) acted, executed the instrument. <br /> <br />I certify under PENALTY OF PERJURY under the laws <br />of the State of California t the foregoing paragraph is <br />true and correct. <br /> <br />Place Notary Seal Above <br /> <br />Signature <br /> <br /> <br />OPTIONAL <br /> <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 /> <br />Description of Attached Document <br /> <br />Title or Type of Document: <br /> <br />Document Date: <br /> <br />Number of Pages: <br /> <br />Signer(s) Other Than Named Above: <br /> <br />Capacity(ies) Claimed by Signer(s) <br /> <br />Top of thumb here <br /> <br />Signer's Name: <br />D Individual <br />D Corporate Officer - Title(s): <br />D Partner - D Limited D General <br />D Attorney in Fact <br />D Trustee <br />D Guardian or Conservator <br />D Other: <br /> <br />Signer's Name: <br />D Individual <br />D Corporate Officer - Title(s): <br />D Partner - D Limited D General <br />D Attorney in Fact <br />D Trustee <br />D Guardian or Conservator <br />D Other: <br /> <br />RIGHT THUMBPRINT <br />OF SIGNER <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 />. <br />@2007 National Notary Association' 9350 De Soto Ave., PO. Box 2402' Chatsworth, CA 91313-2402' www.NationaINotary.org Item #5907 Reorder: Call Toll-Free 1-800-876-6827 <br />
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