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RECORDING REQUESTED BY AND WHEN RECORDED MAIL TO Name Street Address City 6 State Zip SPACE ABOVE THIS LINE FOR RECORDER'S USE Notice of Completion NOTICE IS HEREBY GIVEN THAT: I. The undersigned is the owner of the interest or estate stated below in the property hereinafter described. ?. The full name of the undersigned is city of Colton (NAME). 3. The full address of the undersigned is 650 N. La Cadena Dr. Coltnn CA 92324 (NUMBER AND STREET. CITY. STATE. ZIP). a. The nature of the title of the undersigned is (E.G.. owner in fee OR vendee under contract of purchase OR lessee OR OTHER APPROPRIATE DESIGNATION). >. The full names and full addresses of all persons, if any, who hold title with the undersigned as joint tenants or as tenants in common are: Names Addresses 6. The names of the predecessors in interest of the undersigned. if the property was transferred subsequent to the commencement of the work of improsement herein referred to are (OR IF NO TRANSFER %VAS MADE. INSERT THE WORD "none"): Names Addresses 7. A work of improvement on the propem hereinafter described was completed on Ilpeernber 17, 1999 (DATE). S. The name of the original contractor. if any, for the work of improvement was Kevin O'Keefe Company (NAME OF CONTRACTOR. OR 1F NO CONTRACTOR FOR THE WORK OF IMPROVEMENT .ASA %VHOLE. INSERT THE WORD "none"). [IF NOTICE COVERS COMPLETION OF CONTRACT FOR ONLY PART OF THE %VOR(: OF IMPROVEMENT. ADD: The kind of work done or material furnished was ACfUisition & Installation of playgrotullldd Equip. (GIVE GENERAL STATEMENT. E.G.. furnishing of concrete for sidcwalksl. 9. The property on which the work of improvement was completed is in the City of Colton Count% of San RPrnardino . State of California. and is described as follows: Aquisition & Installation (set forth description of jobsite sufficient for identification. using legal description ifpossible). 10. The street address of the said properly is Cesar E.Chavez-Mt. Vernon, Elizabeth Davis — Laurel (NUMBER AND STREET. OR. IF THERE IS NO OFFICIAL STREET ADDRESS. INSERT THE WORD "none".) Dated: 19 �r�c1 �� (SIGNATURE) Dennis Morris (TYPED NAME) Human Resource Director VERIFICATION 1, the undersigned, say: I am the person who signed the foregoing notice. I have read the above notice and know its contents, and the facts stated therein are true of my own knowledge. I declare under penalty of perjury that the foregoing is true and correct. Executed at , California, this day of , 19 (SIGNATURE) T 420 LEGAL (4.94)