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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 />County of <br /> <br />On~U /'3. 20M! before me, :JE~.bIes. N ~\ ~hi'eJ, <br />Dat~ Here Insert Name an Title of the Officer <br /> <br />personally appeared /f,,/EI..J 55 A- ,?e,-A-7Te <br />Name(s) of Signer(s) <br /> <br />~ /V1 tl -I-.e2J <br /> <br />} <br /> <br />State of California <br /> <br />1- - ~1>:=#~lt:l <br />$~ ~_.Cceda <br />2 ~ san Mateo CounIV - <br />t..._ _~~~~7.:.~ <br /> <br />who proved to me on the basis of;etisfactory evidence to <br />be the person(~ whose name(i~re subscribed to the <br />wit~. instrument and aCknowle~ed to me that <br />h~they executed the same in hi he Vtheir authorized <br />capacity(i~~), and that bX hi~heir Ignature(t) on the <br />instrument the person~, o~ 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 />~~~/12J2 <br />Signature ~ - ~ <br />S' ature of Notary Public <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., 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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