HomeMy WebLinkAboutMINUTES - 09122006 - C.7 (2) TO: BOARD OF SUPERVISORS Contra
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FROM: MAURICE M. SHIU, PUBLIC WORKS DIRECTOR Costa
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DATE: September 26, 2006 County
SUBJECT: Approving Subdivision Agreement (Right-of-Way Landscaping) for Road Acceptance 02-01135
(cross-reference Subdivision 95-07984), being developed by Shapell Industries of Northern
California, a Division of Shapell Industries, Inc., a Delaware Corp., San Ramon (Dougherty
Valley) area. (District 111)
SPECIVIC REQUI-ST'(s)OR RECOMMENDATION(S)&BACKGROUND AND JUSTII--IC.'ATION
RECOMMENDATION(S):
ADOPT Resolution No. 2006/-65 0 for Road Acceptance 02-01135 (cross-reference Subdivision 95-07984),
approving Subdivision Agreement (Right-of-Way Landscaping), for project being developed by Shapell
Industries of Northern California, a Division of Shapell Industries, Inc., a Delaware Corp., San Ramon
(Dougherty Valley) area. (District III)
FISCAL IMPACT:
None.
BACKGROUND/REASON(S) FOR RECOMMENDATION(S):
The landscape plans for Road Acceptance 02-01135 Right-of-Way Landscaping has been reviewed and
processed by Public Works staff and meets all applicable conditions of approval regarding landscape
improvements.
CONSEQUENCES OF NEGATIVE ACTION:
The Subdivision Agreement (Right-of-Way Landscaping) will not be approved.
Continued on Attacltmettt:__L/ SIGNATURE:
_L,13COMNIENDATION OF COUNTY ADMINISTRATOR
RECOMMENDATION OF BOARD COMMITTEE
V70PROVE OTIIER
Ir-
',iIGNATURE S
ACTION OF BVAON<5"Aa-y�7hex4!:: APPROVED AS RECOAIMENDEU OTHER
vo or=supUS(A m w� I hereby certify that this is a true and correct
� UNANI:YIOUS(ABSENT )
AYES: NOES: copy of an action taken and entered on the
ABSENT: ABSTAIN: minutes of the Board of Supervisors on the
I-L:vz date shown.
G:\EngSvc1B0\2006\09-26\RA 02-1135 B0-16.doc
Originator: Public Works(ES)
Contact: T.Ric(313-2363)
cc: Public Works- Construction LL
Current Planning,Community Development ATTESTED: L7�G7' OZO'
T—JuShape
Indusoos(111) JOHN CULLE Clerk of the Board of
Shapell Industries of Northern California ,
loo N.Milpitas Blvd. Supervisors and County Administrator
Milpitas,CA 95035
Attn:Sam Wordcn and Erin Beck
National Fire Insurance Company of l lartlurd
100 N.Milpitas Blvd.
Milpitas,CA 95035By , Deputy
TILE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Adopted this Resolution on September 26, 2006 by the following vote:
AYES: 11ilkenra. Piepho, DeSaulnier, Glover and Gioia
NOES: None
ABSENT: None
ABSTAIN: Notre
RESOLUTION NO. 2006/
SUBJECT: Approving Subdivision Agreement (Right-of-Way Landscaping) for Road
Acceptance 02-01135 (cross-reference Subdivision 95-07984), being developed
by Shapell Industries of Northern California, a Division of Shapell Industries,
Inc., a Delaware Corp., San Ramon (Dougherty Valley) area. (District III)
The following document was presented for Board approval this date for Shapell
Industries of Northern California, a Division of Shapell Industries, Inc., a Delaware Corp.,
located in the San Ramon (Dougherty Valley) area.
A Subdivision Agreement (Right-of-Way Landscaping) with Shapell Industries of
Northern California, a Division of Shapell Industries, Inc., a Delaware Corp., developer,
whereby said developer agrees to complete all improvements as required in said Subdivision
Agreement (Right of Way Landscaping) within two years from the date of said agreement.
Improvements generally consist of landscaping.
Said document was accompanied by the following:
Security to guarantee the completion of right of way landscaping as required by Title 8
and 9 of the County Ordinance Code, as follows:
I. Cash Deposit
Deposit Amount: $3,300.00
Deposit made by: Shapell Industries of Northern California, a Division of Shapell
Industries, Inc., a Delaware Corp.
Auditor's Deposit Permit No. and Date: 409204 July 24, 2003
I hereby certify that this is a true and correct copy of an
1.1-:vzaction taken and entered on the minutes of the Board of
G:\EngSvc\BO\..,006\0)-2,6\RA 02-1135 BO-16.doc
originator: Public works(ES) Supervisors on the date shown.
Contact: T.Ric(313-2363)
cc: Public Works- Construction
Current Planning,Community Development ATTESTED:
July 26,Zoos(Pl)
Shapell Industries of Northern California JOHN CULLEN Clerk of the Board of Supervisors and
Shapell
100 N.Milpitas Blvd. County Administrator
Milpitas,CA 95035
Attn:Sam Worden and grin I leek
National Fire Insurance Company of I lartford
100 N.Milpitas Blvd.
Milpitas,CA 95035 By Q , Deputy
RESOLUTION NO.2006/ �/
SUBJECT: Approving Subdivision Agreement (Right-of-Way Landscaping) for Road
Acceptance 02-01135 (cross-reference Subdivision 95-07984), being developed
by Shapell Industries of Northern California, a Division of Shapell Industries,
Inc., a Delaware Corp., San Ramon (Dougherty Valley) area. (District III)
DATE: September 26, 2006
PAGE: 2
II. Surety Bond
Bond Company: National Fire Insurance Company of Hartford
Bond Number and Date: 929270259 July 10, 2003
Performance Amount: $327,176.00
Labor & Materials Amount: $165,238.00
Principal: Shapell Industries of Northern California
NOW THEREFORE BE IT RESOLVED that said Subdivision Agreement (Right-of-
Way Landscaping) is APPROVED.
All deposit permits are on file with the Public Works Department.
RESOLUTION NO. 2006/590
• SUBDIVISION AGREEMENT
• (Right of Way Landscaping)
(Government Code §66462 and §66463)
Subdivision: RA 1135 (Cross-Ref SUB 7984) Effective Date:
Subdivider: Shapell Industries of Northern California, Completion Period: 1 year
A Division of Shapell Industries, Inc.
THESE SIGNATURES ATTEST TO THE PARTIES'AGREEMENT HERETO:
CONTRA COSTA COUNTY SUBDIVIDER: Shapell Industries of Northern California
A Division of Shapell Industries, Inc.
Maurice M. Shiu, Public Works Director
By. (signur
(pit name title) 1. V
RECOMMENDED FOR APPROVAL:
By: (sign i
Engineering Servicesi isi (print n me&title)
FORM APPROVED: Victor J. Westman, County Counsel
(NOTE:All signatures to be acknowledged. If Subdivider is incorporated,
signatures must conform with the designated representative groups
pursuant to Corporations Code§313.)
1. PARTIES&DATE. Effective on the above date,the City of County of Contra Costa,California,hereinafter called"County,"and the
above-mentioned Subdivider, mutually promise and agree as follows concerning this subdivision:
2. IMPROVEMENTS. Subdivider agrees to install certain road improvements (both public and private), drainage improvements,
signs, street lights, fire hydrants, landscaping, and such other improvements (including appurtenant equipment) as required in the
improvement plans for this subdivision as reviewed and on file with the Contra Costa County Public Works Department and in conformance
with the Contra Costa County Ordinance Code(including future amendments thereto).
Subdivider shall complete said work and improvements(hereinafter called"work")within the above completion period from date
hereof as required by the California Subdivision Map act(Government Code§§66410 and following), in a good workmanlike manner,in
accordance with accepted construction practices and in a manner equal or superior to the requirements of the County Ordinance Code and
rulings made thereunder; and where there is a conflict between the improvement plans and the County Ordinance Code, the stricter
requirements shall govern.
3. IMPROVEMENT SECURITY. Upon executing this Agreement,the Subdivider shall,pursuant to Government Code§66499,and
the County Ordinance Code, provide as security to the County:
A. For Performance and Guarantee: $ 3.300cash,plus additional security,in the amount of
$ 327,176. which together total one hundred percent(100%)of the estimated cost of the work. Such additional security is presented
in the form of:
Cash,certified check or cashiers check.
X Acceptable corporate surety bond.
Acceptable irrevocable letter of credit.
With this security,the Subdivider guarantees performance under this Agreement and maintenance of the work for one year after its
completion and acceptance against any defective workmanship or materials or any unsatisfactory performance.
B. For Payment: Security in the amount of$ 165.238, which is fifty percent(50%)of the estimated cost
of the work. Such security is presented in the form of:
Cash,certified check, or cashier's check
X Acceptable corporate surety bond.
Acceptable irrevocable letter of credit.
With this security,the Subdivider guarantees payment to the contractor,to his subcontractors,and to persons renting equipment or
furnishing labor or materials to them or to the Subdivider.
C. Upon acceptance of the work as complete by the Board of Supervisors and upon request of the Subdivider,the amount
securities may be reduced in accordance with §94-4.406 and§94-4.408 of the Ordinance Code.
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT,
( State of California
County of ss._. f�(�1-C'A CL1� 2�
,I
On 'f� � before me, L�s
Dae ---�� Name and Title of Officer e.g.."Jane Doe,Notary Public") "n,, n I
personally appeared _ -C- \�� �����'' �r, "N P4ceQAAt9 I
Name(s)of Signer(s)
personally known to me I
❑ proved to me on the basis of satisfactory
evidence
to be the person(s) whose name(s) jsfare i
subscribed to the within instrument and 1
JANICE T-KRUSE acknowledged to me that hefsfiefthey executed 1
Commission# 1318697 the same in hi&#ireetheir authorized
Notary Public-California ca acit (fes and that b h.L%A+erftheir 1
Santa Clara County signature(s) on the instrument the person(s), or
MVCW=.EVkwAug24,2W4 the entity upon behalf of which the person(s)
acted, executed the instrument.
W NESS my hand and official
Signature of Notary Public
i OPTIONAL.
Though the information below is not required by law,it may prove valuable to persons relying on the document and could prevent
f' fraudulent removal and reattachment of this form to another document.
Description of Attached Document
�^ 1
Title or Type of Document: ✓ c��y S t �.J �� I�= 1
Document Date: Number of Pages:
Signer(s)Other Than Named Above:
Capacity(les) Claimed by Signer
Signer's Name:
f
❑ Individual [� p (�� (� Top of thumb here
eCorporate Officer—Title(s): �S�S j
❑ Partner— -1 Limited ❑General
❑ Attorney-in-Fact l
❑ Trustee
i ❑ Guardian or Conservator
❑ Other:
Signer Is Representing
0 1999 National Notary Association•9350 De Soto Ave.,P.O.Box 2402•Chatsworth,CA 91313-2402-www.nationalnotary.org Prod.No.5907 Reorder:Call Toll-Free 1-800-876-6827
COUNTY.OF CONTRA COSTA
DEPOSIT.PERMIT
—"1 OFFICE OF COUNTY AUDITOR-CONTROLLER J
TO THE TREASURER: MARTINEZ,CALIFORNIA f�(
RECEIVED FROM U
ORGANIZATION NUMBER ���
(()) ( )
(For Cash Collection Procedures see County Administrator's Bulletin 105.)
DESCRIPTION FUND/ORG. C,CT TASK OPTION ACTIVITY AMOUNT
$
V10
�-/ kEt/ 0A)9_5 R-5 '50
,�11 ILI I I I I I I I 1 11 1 1 3P qD
N U�SDd ��Dl`I� Dlo ADD
)Ti_:rtjVI
g/65 6 OISVe X55 'S
10, 05 �jtJ iY
Pq()q q350
Y
111,141111LI I ILI IIILIIII
&.D `738 3/ Y/
- 9 l 035--:20
i < D"fJ-22- c!) CS R `�
Ir ,2.131
Lx Cull IV TU y: C l ��7 ��r� to L/� X 3od ;Oct
EXPLANATI N: TOTAL $ I
���, ! DEPOSIT D,Y,
Desit consists of the following items
-.-E'OIN and CURRENCY $
t {��Z63,7j- ��0��� BANK DEPOSITS C $����/��c�I
FOR-AUDITOR-CONTROLLER USE ONLY
Jl LI J�3 DEPOSIT
-j[:.. 76W10 0�; C PERMIT pp
[ r r < r NUMBER
DATE
ASSIGNJP9204 JULrN tel
The amount of money described above is for Treasurer's receipt of above amount is approved. Receipt of above a'nount is hereby
deposit into the County
fTreasury. acknowlahxJ
dd
Date�� Signed: Signed: L.
Tit ('.�(t �VI-EXT. - �L/ Dep unty Audi Deputy County Treasurer
D-34 REV.(7.93) '
q �
( . L-S t-j l-I LA, f3AQaA,eH,CDD
819800-0800: 61120514, $1,200.00, Sub 8688, Cash Performance Bond
(landscape), Shapell Industries of N. California, 100 N. Milpitas Blvd.
Milpitas, CA 95035
819800-0800: G1120515, $4,600.00, Sub 8632, Landscape Cash Bond,
Shapell Industries of N. California, 100 N. Milpitas Blvd. Milpitas, CA 95035
819800-0800: 61120516, $3,300.00, RA1135, Landscape Cash Bond, Shapell
Industries of N. California, 100 N. Milpitas Blvd. Milpitas, CA 95035
0649-9665 / 831000: 61120514,$9,100.00 Sub 8688, Landscape Inspection
Shapell Industries of N. California, 100 N. Milpitas Blvd. Milpitas, CA 95035
0649-9665 / 831000: &1120515,$24,300.00 Sub 8632, . Landscape
Inspection Shapell Industries of N. California, 100 N. Milpitas Blvd. Milpitas,
CA 95035
0649-9665 / 831000: G1120516, $18,400.00, RA1135, Landscape
Inspection, Shapell Industries of N. California, 100 N. Milpitas Blvd.
Milpitas, CA 95035
0649-9665 / 831000: G1116893, $2,686.27, 508531, Map Checking deposit,
Janin Associates, 957 Stow Lane, Lafayette, CA 94349
0649-9665 / 831000: G1116895, $805.43, M5 8-99, Inspection Deposit,
Premium Property Development, 428 N. Buchanan Cir Ste 14, Pacheco, CA
94553
0649-9665 / 831000: 61116896, 1221 Monticello Limited Partnership, 1485
Enea Ct., Suite 1490, Concord, CA 94520-5228
$6,330.00, Ms 02-0022, Improvement Plan Check
$1,600.00, M5 02-0022, PM Chcek
0649-9665 / 831000: G1116899,$500.00, R52813, Record of Survey
Deposit, Kristy Huffacker, 2337 Walnut Blvd, Walnut Creek, CA 94597
Gale Ranch II
Subdivision: RA-1135 (Cross Ref. SUB 7984)
Bond No.. 929270259
Premium: $2,454.00
IMPROVEMENT SECURITY BOND
FOR PUB-Lw RIGHT OFW.AYLANDSCAPE AGREEI4IENT
(Perfonnance, Guarantee, and Payment)
(California Govertnnent Code.Sections 66462 and 66463)
1. REcrrAL OF SUBDIVISION AGREEMENT: The Principal lia.s executed an agreementwith the County to instill
and pay for public right of way landscaping, and other related fig)rovennents in Subdivision RA-1135 (Cross
gef SUB 7984) as specified in the Su:txiivisi.on Agreen nt (Riglit of Way Landscaping), mid to
complete said work within the time specified for completion in the Subdivision Agreement (Right of Way
Landscaping), all in.accordance with State and local laws andrulings thereunder in.order to satisfy conditions
for fling of the Final Map or. Parcel Map for said Subdivision.
Shapell Industries of Northern California, A
2. ORLIGATTON: Division of Shapell Industries, Inc., a Delaware Corp. }aS Plinc tul,and
National Fire Insurance Company of Hartford _ __ ,a corporation organized existing under the laws-
of
awso.f the State of CT , and autborized to transact surety business in California,
as Surety, hereby jointly and severally bind ourselves,our heirs, executors, administrators, successors, and
assigns to the County of Cxmitra Costa, California to pay it:
Three Hundred Twenty Seven.Thousand One
A. Performauce and Guarati.tee: Hundred Seventy Six Dollars and 00/100
Dollars($ 327,176.00 ) for itself or any city assignee under the above County
Subdivision Agreement, plus
B. Payment: One Hundred Sixty Five Thousand Two Hundred Thirty Eight Dollars and 00/100
Dollars ($ 165,238.00 ) to sercwwe the clainis to which..reference is.hole in Title
.XV (cone ienciing with. Section. 3082) of Pili 4 of Division 111 of the Civil Code of the State of
California.
3. Cox. Di'nQN:
A. Tlie Condition of this obligation as to Section 2.(A) above is such that if the above bounded Principal,
his of its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide
l-)y, an- �ve11 and truly keep and perforni the covenants, conditions and previsions in the said
agreemen=t and any alteration thereof made as therein provided, on is or its part, to be kept and
rein specified, and lin all.respects according t0 their true
perfori'md at the time and hi tine inanner the
intent kid meaning, and shall indennnify and save harinless the County of Contra Costa (or. city
I...aassignee), its officers, agents and employees, as therein stipulated, then this obligation shall become
null and void; otherwise.it shall he anal.reniaiin in full force and effect.
NOTICE
In accordance with the Terrorism Risk Insurance Act of 2002, we are providing this
disclosure notice for bonds and certain insurance policies on which one or more of the
Writing Companies identified below is the surety or insurer.
To principals on bonds and insureds on certain insurance policies written by any one or
more of the following companies (collectively the "Writing Companies") as surety or
insurer: Western Surety Company, Universal Surety of America, Surety Bonding
Company of America, Continental Casualty Company, National Fire Insurance Company
of Hartford, American Casualty Company of Reading, PA, The Firemen's Insurance
Company of Newark, NJ, and The Continental Insurance Company.
DISCLOSURE OF PREMIUM
The premium attributable to coverage for terrorist acts certified under the Act was Zero
Dollars ($0.00).
DISCLOSURE OF FEDERAL PARTICIPATION IN PAYMENT OF TERRORISM
LOSSES
The United States will pay ninety percent (90%) of covered terrorism losses exceeding the
applicable surety/insurer deductible.
Form F7310
POWER OF ATTORN APPOINTING INDIVIDUAL ATTOOEY-IN-FACT
Know All Men By These Presents, That CONTINENTAL CASUALTY COMPANY, an Illinois corporation, NATIONAL FIRE INSURANCE
COMPANY OF HARTFORD, a Connecticut corporation,AMERICAN CASUALTY COMPANY OF READING, PENNSYLVANIA,a Pennsylvania
corporation(herein collectively called"the CCC Surety Companies"), are duly organized and existing corporations having their principal offices in
the City of Chicago,and State of Illinois, and that they do by virtue of the signature and seals herein affixed hereby make, constitute and appoint
Marie A. Cook, Individually
of Milpitas, California
their true and lawful Attomey(s)-in-Fact with full power and authority hereby conferred to sign, seal and execute for and on their behalf bonds,
undertakings and other obligatory instruments of similar nature
-In Unlimited Amounts-
and to bind them thereby as fully and to the same extent as if such instruments were signed by a duly authorized officer of their corporations and
all the acts of said Attorney, pursuant to the authority hereby given are hereby ratified and confirmed.
This Power of Attorney is made and executed pursuant to and by authority of the By-Laws and Resolutions, printed on the reverse hereof,
duly adopted, as indicated, by the Boards of Directors of the corporations.
In Witness Whereof,the CCC Surety Companies have caused these presents to be signed by theirGroup Vice President and their
corporate seals to be hereto affixed on this 18th day of June 1998
CONTINENTAL CASUALTY COMPANY
NATIONAL FIRE INSURANCE COMPANY OF HARTFORD
re �, y`� Y� AMERICAN CASUALTY COMPANY OF READING, PENNSYLVANIA
� AMY ar.
J SEAL
1897
JfAR'T d�
Marvin J.Cashion Group Vice President
State of Illinois, County of Cook,ss:
On this 18th day of June 1998 ,before me personally came
Marvin J. Cashion,to me.known,who, being by me duly sworn,did depose and say:that he resides in the City of Chicago,State of Illinois;that
he is a Group Vice President of CONTINENTAL CASUALTY COMPANY, NATIONAL FIRE INSURANCE COMPANY OF HARTFORD, and
AMERICAN CASUALTY COMPANY OF READING, PENNSYLVANIA described in and which executed the above instrument;that he knows the
seals of said corporations;that the seals affixed to the said instrument are such corporate seals;that they were so affixed pursuant to authority
given by the Boards of Directors of said corporations and that he signed his name thereto pursuant to like authority,and acknowledges same to
be the act and deed of said corporations.
'(440
NOTARY
puguG
hook
My Commission Expires March 6,2000 Mary Jo Abel Notary Public
CERTIFICATE
I, Mary A. Ribikawskis,Assistant Secretary of CONTINENTAL CASUALTY COMPANY, NATIONAL FIRE INSURANCE COMPANY OF
HARTFORD,and AMERICAN CASUALTY COMPANY OF READING, PENNSYLVANIA do hereby certify that the Power of Attorney herein
above set forth is still in force,and further certify that the By-Law and Resolution of the Board of Directors of each corporation printed on the
reverse hereof are still in force. In testimony whereof I have hereunto subscribed my name and affixed the seals of the said corporations
this ld+ 1 day of JULY CruT
92
CONTINENTAL CASUALTY COMPANY
GAS UqtTI :•y„SUrr'��yc. `o�oaf>Nroe� NATIONAL FIRE INSURANCE COMPANY OF HARTFORD
re AMERICAN CASUALTY COMPANY OF READING, PENNSYLVANIA
2ly �x>fl.1 �.� •,• � - o��pG�OrtoT� w
Q.
Z a
JULY 31, '�
ov
SEAL s 1902 -S`
—111h
Mary A. Ribikawskis Assistant Secretary
w.10/1/97)
STATE()F
5J.
COU" TY DF... .......
Oil
PERSt):!NALIY APPEAW-0 Marie A. Cook
personally hilown to me �r.r r .. ..7 to of
to be the per3!)Yli 6V)IUSf` YiarYico
subscribed to to t.he'.vvith.in instrument-and.ac.liixClwIt',(.lged to me
t.li�i.t.1 /she/executed the sarrie iris/tier/t lutlioriz d
capacityand that. oil the
instrument the or the er►tit)r upon behalf of which � JANICET(CRUSE
the pemorx<actecl,executed the instrument. COmmi£ssion91318697 Z
NObuy Public-California z
V11:['FNESS my hand and official steal. Santa Clara County
liAy CtmM f�tlms Aug 24,2W5
—y
Sign.at: :'.. .......... ....................... - ..__...__._._......._._.........".....`.`..............................._ 71.i5 areai.irar()ffic.h.t N14na.rial Sart?
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document and could
provent fr.:iudu)erit reattachment of this fora).
CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT
INDIVIDUAL
i_ CORPORAI E. OFFICER
TITLE OF TYPE OF DOCUME::N f
i.....I PARTNER(S) L! LIMITED
❑ GENERAL
0 AFFORNEY IN-FACT NIJME3E::t:OF PAGES
TRUSTEE(S)
GUAR MANAX)NSE=RVAI-oR
...i OTHER:
......_.........................................................._................_...._........._..._.................._.........................................._.............._...........
DATE OF DOCUMENT
SIGNER IS REPRESENTING-
NAME
EPRESENTING-NA;tE QF PERSON($)OR ENTITY(IES)
National Fire Insurance Company of HartfordSIGNER{S)OTHER THAN NAMED ABOVE
11.1 O i1 Rim 6194 ALL-PURPOSE ACKNOWLEDGEMENT
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
( State of California
County of Pt (��1� Cum 2i� ss
On 3 before me,
Date , Name and Title of Officer(e.g.,'Jane Doe.Notary Public")
i personally appeared 1 Y R e �� -C�p� N}N RV_ ►`�S l'4/��
Name(s)of Signer(s)
r personally known to me I
� proved to me on the basis of satisfactory l
evidence
I
,� .. � �, to be the person(s) whose name(s) +R/are
JA�IICET.fCRUSE subscribed to the within instrument and
�� Commission 01318697 �t acknowledged to me that hefsh /they executed
z ea Notary Public-California the same in Hsihet/their authorized
Santa Clara County capacity(ies), and that by hi~their
*Comm.E*I=Aug24,2lX5 signature(s) on the instrument the person(s), or
the entity upon behalf of which the person(s) I
acted, executed the instrument.
TNESS my hand and official
Signature of Notary Public
1
OP
Though the information below is not required by law,it may prove valuable to persons relying on the document and could prevent
fraudulent removal and reattachment of this form to another document.
I Description of Attached Document
Title or Type of Document: LFX (L1 P"--�P_ . o
Document Date: Number of Pages:
Signer(s)Other Than Named Above: I
Capacity(ies) Claimed by Signer
Signer's Name:
I �
I' _ [ 10 \ I 1 lop of thumb here
Corpporatrate Officer—Title(s): SS S
C Partner— -] Limited __1 General
Attorney-in-Fact
r F7. Trustee I
Guardian or Conservator
1 Other:
1
Signer Is Representing
®1999 National Notary Association•9350 De Soto Ave.,P.O.Box 2402•Chatsworth,CA 913132402•www.nationalnotary.org Prod.No.5907 Reorder:Call Toll-Free 1-800-876-6827