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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 /> <br />~~~~~~ <br /> <br />State of California <br />County of SaN M/freO <br />On 'J)~ / g, ;2.00 8" before me, <br />Dale <br /> <br />} <br /> <br />personally appeared <br /> <br />Ii R :TC:A-N <br /> <br />Here Insert Name ..aM Title of the Officer <br /> <br />A)ELJ 55 A- '?LArr~ <br />~ Name(s) of Signer(s) <br /> <br /> <br /><?uh/tQ.j <br /> <br />, <br /> <br />~.. ~ ~ .... "w;~RoLS - , <br />@"CommIsaIOn#I621316 <br />3 .. Notary P\dC . CaIIfomIa I <br />t - . San Mateo Ccu1Iy - <br /> <br />t _ ..I _ ~~~~~~7.:.20~~ <br /> <br />who proved to me on the basis o~isfactory evidence to <br />be the person(1) whose name(tJJyrare subscribed to the <br />within instrument and acknowle~ to me that <br />he8!they executed the same in hi~their authorized <br />capacity(i~~), and that by hi~their slgnature~) on the <br />instrument the person~, o~e 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 that the foregoing paragraph is <br />true and correct. <br /> <br />Place Notary Seal Above <br /> <br />WITNESS my hand and official seal. <br /> <br />Signature ~~ <br />. ature of Notary Public <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 />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 />~v-=.~~=~~~~y~. <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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