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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 />~--:--'-~._-''='=-=-=-=--'___~~~_A~A~A=A~~ <br /> <br />personally appeared <br /> <br />} <br /> <br />before me, .A1t?Ry .1/I1J13l:l,et.r'a1im..J2i.fihJ/~ <br />.AlE:. U s.s' A- '1=ZA-71~ <br /> <br />...... Name(s) of Signer(s) <br /> <br />State of California <br /> <br />County of ~ Pako <br />onVli!-18,dJ;o$ <br /> <br />Da1e <br /> <br />1- - ~ l' :=:=.-, <br />i~' NotarY N* . CaIIOInIa I <br />. san MQIeO ~ <br />t _ _ _ ~~:~~7:20~ <br /> <br />who proved to me on the basis of ~tisfactory evidence to <br />be the person~ whose name~@lare subscribed to the <br />wit~. instrufnemt and acknowled~ to me that <br />he&hey executed the sa~'n hi~heir authorized <br />capacity(i~), and that by hi e Vtheir signature(~ on the <br />instrument the person(~, 0 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 />WITNESS my hand and official seal. <br /> <br /> <br />Signature~~ <br />Place Notary Seal Above Signature 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 />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 />~~~~~'V'=V'~~~ <br />@2007 National Notary Association. 9350 De Solo Ave., P.O. Box 2402. Chalsworth. CA 91313-2402. www.NationaINotary.org Item #5907 Reorder: Call Toll-Free 1-800-876-6827 <br />
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