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Agmt11 American Asphalt Repair and Resurfacing Co.
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Agmt11 American Asphalt Repair and Resurfacing Co.
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Last modified
7/12/2012 3:24:20 PM
Creation date
8/9/2011 1:26:01 PM
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Template:
Agreement
Contractor Name
American Asphalt Repair and Resurfacing Co.
PROJECT NAME
2010-2011 Slurry Seal Project
RMP File Number
304
Date
8/9/2011
MO Ref
11-113, 12-066
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� ��. • CALIFORNIA ALL-PURPOSE <br /> CERTIFICATE OF ACKNOWLEDGMENT <br /> State of California � <br /> County of Butte <br /> On 7/20/201 I befOre m0, Elizabeth Collodi, Notary Public <br /> (Flere insert name and title of the officer) <br /> personally appeared Barbara Beeny y <br /> who proved to me on the basis of satisfactory evidence to be the perso�s.) whose nameEs-) is/aresubscribed to <br /> the within instrument and acknowledged to me that-ke/she/tise� executed the same in k�s/her/t�eir authorized <br /> capacity(.� and that by-I�s/her/�-signatureEsj-on the instrument the perso�s} or the entity upon behalf of <br /> which the perso+�sj�cted, executed the instrument. <br /> I certify under PENALTY OF PERJLTRY under the laws of the State of California that the foregoing paragraph <br /> is true and correct. <br /> WITNESS my hand and official seal. EUZABETHCOILODI <br /> COMM. # 1878873 <br /> fi �;;'' r+a�rnar Pueuccu�oaHw <br /> . � ouNrr oF eur� <br /> Signature o( tary Public o Cc,ncn. EryLlSFE$.1,2014 <br /> ADDITIONAL OPTIONAL INFORMATION <br /> INSTRUCT[ONS FOR COMPLETING THIS FORM <br /> Any acknoivledgmen( comple�ed in Cu( fornia must roniain verbiage esact(y as <br /> DESCRIPTION OF THE ATTACHED DOCUMENT appeurs above in !he no�ury section ar a sepura(e acknmidedgmenlform uinst he <br /> proper(y cmnple(ed and atmched ro(hat documenG The ottly escep(ion is if a <br /> Performance& Payment Bonds docun�en! is (o be recorded ou(side ofCalfornia. Li such imstuuces, mry a[[ernolive <br /> acknowledgmen[ verbiage as way be prinled on such a dacwnenl so (ong as O�e <br /> (Title or descripiion of atlached documenQ verbiage does not reyuire �he �rotary m do swue�hing (h�( is i((egalfor a notnrv in <br /> American Asphalt Repair and Resurfacing, Inc. Calrjornia (i.e. cert fying �he uu�horiaed capaciry ojrl:� stg�,�.�. Please check �he <br /> Aan�ment caref d(y for proper notarip! wordiag and unuch Uiis forrn f required <br /> (Title or descrip[ion of attached docmnent conlinucd) <br /> Nuntber of Pages 4 Docnment Date��Z��z� � 1 • State and County infoemation must be the State and County where the document <br /> signer(s) personally appeured be(ore the notery public for acknowledgment. <br /> • Date o( notarization must be the date that the signer(s) personalty appwred which <br /> The Guarantee Company of North America USA must also be the same date the acknowledgment is completetl. <br /> (Addi�ional informa�ion) • The notary public mus[ print his or her name as it appears wi[hin his or her <br /> commission followed by a comma and [hen your [itle (no[ary public). <br /> • Print tlie name(s) of documen[ signer(s) who pecsonally appear at Ihe time of <br /> no�arization, <br /> CAPACITY CLAIMED BY THE SICiNER • Indicate Ihe correct singular or plural fonns by emssing off incorrect forms (i.e. <br /> ❑ Individual (S� MeFshe/N�y, is/a�e-) or circling [he correct forms. Failure to correctly indica[e this <br /> informa�ion may lead [o rejection of documen� recording. <br /> ❑ Corporate Officer • The notary seal impression must be clear and photographically repmducible. <br /> � Impression musl no[ cover [ex[ or lines. If seal impression smudges, re-Seal if a <br /> (Title) sufficient eree permi[s, otherwise complete a differem acknowledgmen[ fonn. <br /> ❑ Par[ner(s) • Signature of the no[ary public must ma[ch tlm signamre on file with the off ce of <br /> ihe county clerk. <br /> � Allorney-in-Fac[ *- Addi[ional information is no[ required bu[ could help to ensure this <br /> ❑ TrUS[ee(S) ocknowledgment is not mis�sed or atinched to a different dacument. <br /> '.- Indica[e title or type of attaehed document, number of peges and dafe. <br /> ❑ O[her *,- Indicate the capaciry claimed by tlie signer. If[he claimed capacity is a <br /> mrpora�e officer, indica�e the tiile (i.e. CEO, CFO, Secretary), <br /> � • Sewrely a[[ach [his documen[ to [he signed document <br /> 2008 Version CAPA 02.10.07 800-873-9865 www NotaryClasscs.wm , <br />
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