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STATE OF CALIFORNIA <br />ss. <br />CITY OF ) <br />On this day of , in the year 20 , before me, <br />a Notary Public in and for said state, personally appeared <br />known to me to be the person whose name is <br />subscribed to the within instrument as the Attorney -In -Fact of the (Surety) acknowledged to me <br />that he subscribed the name of the (Surety) thereto and his <br />own name as Attorney -In -Fact. <br />Notary Public in and for said State <br />(SEAL) <br />Commission expires: <br />NOTE: A copy of the Power -of -Attorney to local representatives of the bonding company must <br />be attached hereto. <br />CONTRACTOR'S CERTIFICATE REGARDING <br />WORKERS' COMPENSATION <br />18 <br />