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Agmt09 Mental Health Association of San Mateo County
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Agmt09 Mental Health Association of San Mateo County
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Last modified
7/28/2009 12:19:39 PM
Creation date
7/21/2009 9:54:42 AM
Metadata
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Template:
Agreement
Contractor Name
Mental Health Association of San Mateo County
PROJECT NAME
Owner Participation Agreement
RMP File Number
405
Date
12/13/2008
Reso Ref
RD 08-09
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<br />CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT <br />6<>6'('~~~~~;C<:>~~~;C<:>~~~~~~~,w~~;c<:>~~,mr-~~-W-W~~;C<:>~~~~~ <br /> <br />County of 4~ /l}/.f~ <br /> <br />On ~v ~~. 4p~9 <br />Date <br />personally appeared '~V/A <br /> <br />before me, "" T. m.G.e~N ;V;/~ <br />Here Insert Name and Title of the Officer <br /> <br />0NLJJ?L'L/dOEN' <br />Name(s) of Signer(s) <br /> <br />} <br /> <br />.4-,i./e/, <br /> <br />State of California <br /> <br />)'1- ~ - - =::.1 <br />I. Notary PublIC - California ~ <br />t San_COU1ly ~ <br />,.. ,.. __ t'V:o:m~~__~2~ <br /> <br />who proved to me on the basis of satisfactory evidence to <br />be the person~ whose name~are subscribed to the <br />with~")instrument and acknowledg~ to me that <br />he~hey executed the same in hi~heir authorized <br />capacity~, and that by his~heir signature~ on the <br />instrument the person~, or the entity upon behalf of <br />which the personVtf acted, executed the instrument. <br /> <br />Place Notary Seal Above <br /> <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 />o Individual <br />o Corporate Officer - Title(s): <br />o Partner - 0 Limited 0 General <br />o Attorney in Fact <br />o Trustee <br />o Guardian or Conservator <br />o Other: <br /> <br />Signer's Name: <br />o Individual <br />o Corporate Officer - Title(s): <br />o Partner - 0 Limited 0 General <br />o Attorney in Fact <br />o Trustee <br />o Guardian or Conservator <br />o 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., P.O. Box 2402. Chatsworth, CA 91313-2402. www.NationaINotary.org Item #5907 Reorder: Call Toll-Free 1-800-876-6827 <br />
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