HomeMy WebLinkAboutMINUTES - 01152002 - C.23 TIDE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Adopted this Resolution on January 15, 2002,by the following vote:
AYES: Supervisors Uilkema, Gerber, DeSaulnier, Glover and Gioia
NOES: None
ABSENT: None
ABSTAIN: None
RESOLUTION NO. 2002/ 21
SUBJECT: Approval of Road Improvement Agreement for Bollinger Canyon Road, RA 1108
(cross-reference Subdivision 79761), being developed by Windemere BLC Land
Company, LLC, Dougherty Valley area. (District III)
The following document was presented for Board approval for Bollinger Canyon Road,road
acceptance file RA 1108 (Subdivision 7976) property located in the Dougherty Valley area,
Supervisorial District III.
A Road Improvement Agreement with Windemere BLC Land Company, LLC, principal,
whereby said principal agrees to complete all improvements, as required in said road improvement
agreement, within one year from the date of said. agreement. Improvements generally consist of
roadway and drainage improvements.
Said document was accompanied by security to guarantee the completion of road
improvements, as required by Title 9 of the County Ordinance Code, as follows:
I hereby certify that this is a true and correct copy of an action
taken and entered on the minutes of the Board of Supervisors
Originator: Public Works(ES) on the date shown.
Contact: Teri Rie(313-2363)
G:\GrpData\EngSvc\BO�20011Temp\RA 1108 BO 15.doc
4VL:1ad ATTESTED: .January 1S , 2002
cc: Pubic Works- R.Bruno,Construction
Current Planning,Conununity development JOHN SWEETEN, Clerk of the Board of Supervisors and
T-11.15-02(PI)
Windemere BLC,LLC County Administrator
3130 Crow Canyon Place,#310
San Ramon,CA 94583
The American Insurance Company
5 Peters Canyon
Irvine,CA 92606 By ,Deputy
RESOLUTION NO.20021 21
SUBJECT: Approval of Road Improvement Agreement for Bollinger Canyon Road,RA 1108
(cross-reference Subdivision 7976),being developed by Windemere BLC Land
Company, LLC,Dougherty Valley area. (District 111)
DATE: January 15, 2002
PAGE: 2
I. ,,-"Cash Band
Performance Amount: $11,000.00
Auditor's Deposit Permit No. DP 379205 Date: December 24, 2001
Submitted by: Windemere BLC Land Company, LLC
Taxpayer identification number: 94-329-15-16
H. Surety Bond
Bond Company: The American Insurance Company
Financial Institution/Bond Number and Date: 11133599347, December 19, 2001
Performance Amount: $1,094,900.00
Labra& Materials Amount: 553,000.00
Principal: Windemere BLC Land Company, LLC
NOW, THEREFORE, IT IS RESOLVED that said road improvement agreement is
APPROVED.
All deposit permits are on file with the Public Works Department.
RESOLUTION NO. 2002/21
Bond No.. 111 3359 9347'
DeVeJapautir RA 1108 X- e Sib � 7£
Premium; $3,832.00
YoR RGA IwaovEgen AGazEmmw
(Ferfbnuance, Gum intee, and Payment)
(CalifMMia Govexnttent Code § 56499..66499.10)
I. ftcrrAL.o»Roan TxrarawasmrxT AGitrrm= ila Davaloper{I'zi cspal) has=wuvcd run agreemcnt
(Road ,Improvement Agreement) with the County to install and pay for street, drainage and other
imprcp�em s on,or along Bollinger CanyonRoams to complete said word:within the time specified
for completion in the Road lmpmvement Agreenteut,all in accordance With Stare and local laws and rulings
2. Windemere BLC Land Com an LLCas Principal
m. . .r The• eri arcs-I-. . nte*
a corporation orgareci under the laws ofthe State of Nebraska
and authorized to fact surety business in California, as Surety, hereby jointly and severally bind
ourselves, our heirs, executors, administrators, successors and assists to the County of Contra Costa,
Califar�to pay as follows
Company
A. Pearfo rMaUge. One Million. Ninety Four Thousand Nine Hundred -and no/100
f3ailazs 094,902 00 ,� for itself or any city assignee Under the above County
Road Improvement Agreement,plus
R. plyMent: Five Hundred Fif ty Three Thousand and no/100
Uollarss(S' 553 , 00 00 1 to sect the claim to which{reference is made.in
Title 15 §§ ct seq. of the Civil Code ofthc Stare ofCaliforoia,
3. CONDMOW.
A. The Condiliou offts obligation as to Section(2.A.)above is such that if the above bonded Principal,
or principal's heirs, executors, adrnirtistrators,successors or assigns,shall is all things stand to and
abide by and wall and truly keep and perform rhe covenants, Conditions and provisions in the said
agreement and any alteration thereof made as therein provided on it or its part, to be kept and
petfcur ned at the time and in the manner therein specified and is all resptcts according.to their true
intent and meaning and shall indemnify and save harmless the County of Contin Cosm or city
sssi�:aee, its offices., agents and employees,as'therein stipulated, then this obligation shall become
null;��d ,)ids otherwise it shall be and remain in full farce and effect.
As pact of the obligation 6=uvrl hereby and in addition to the face amount spud tluar+efixr%them
shall be included reasonable.casts,expense;and fees,including reasonable attomey's fps,incurred
by the Couiuty of Contra Costa or city assignee,in successfully enfD=iA8 such obligatim all to be
taxed as costs and included in any judgeaaaem renderer
B. nV conditiou of this obligation, as to Section (2.B) above, is such thaf said Princitpal and the
undmigaed as cotporatc surety are held firmly bound unto the County of Contra Costa and all
contractors,subcoatrsu urs,laborers,material men and otherpersons employed in the perfe==c
of the aforesaid agreement and referred to in the aforesaid Civil Code, for rmat xWS furnished,labor
of any kind,or for armotmts due under the Unemployment Insurance Act with rwpOd to such work
or labor and that said undersiptd surety will pay the$erne in an aruotunt not excr. g the amount
herein above set forth and also,incase suit is brought upon this bond,will pay,in addition to the fact
amount thereof,reasonable casts,expenses and k=,including reasonable attorney`s foes,incurred
by the County of Cancra Casts or city i egaas costs d to b�utt�cludcd orcinm the,3udbhg gationth+eacsa
awarded arA fixed by the count, all to be d
rendered.
It is hereby expressly stipulated and agreed that this band shall inure to the benefit of any arA all
persons,cormpan.es and corporations entitled to file claims undcar Title 15
(cotam+mczn$with Sectiaaa
3082 of Part 4 of Division 3) of the Civil Codeof the S=��forma,so as to dive a right of
action to them or their assigns in any suit brought upon flusboud.
Should the Quark under the conditions of this bond be fully perfouzued, thea this obligation
shall
become Wali and void; otherwise it shall be and retnaiu in full force acrd effect.
C. Na altecanon of said Read Improve7nent Agreement or any plata or specification of said vrork agreed
to by the Principal and the County shall relieve the Surety from liability on this bond and consent
is hereby given to maks such alteration without further notice 14 or cousaa by the Surety and the
Surety hereby waives tate Provisions of California Civil Code Se+ctoa 2819 and holds itttself bound
without regard to and independently of any action agaunt Principal Whenever taken.
4. SIGNED AND SRAI..LD*.
The undersigned executed this doaEu c nt ort
' December 2001
WINDEMERE BLC LAND COMPANY, LLC
By: Lennar Homes of California, Inc. SMTY-. THE AMERICAN INSURANCE COMPANY
PRI CVA, " its mann er
Adm; 5 Peters Canyon
Atich�=$s: 31 3 C Crow Can o
City: Imine, CA 92606
City
�- " By: r
-�, Pti'pt Nom: Patricia Brebner
I"riatN no: Lawrence H Thomas_
Title:
Vice President Title: At"Ctamey-in Fact
...............................
....................................................................
................................._...... ____
CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT
State of California
County of Oranm
On December 19. 2001 before me, S. McDonald, Notary Public, personally
appeared Lawrence H. Thom soon, personally known to me to be the person whose
name is subscribed to the within instrument and acknowledged to me that
he executed the same in his authorized capacity, and that by his signature
on the'instrument the person or the entity upon behalf of which the person
acted, executed the instrument.
Witness my hand and official seal.
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER SIGNER IS REPRESENTING:
Corporate Officer— Vice President Lennar Homes of California Inc.
QESCRIPTON OF ATTACHED DOCUMENT
Type of Document: Bond No. 111 3359 9347
Number of Pages: Two (2)
Date of Document: December 19, 2001
Signers (other than those named above): Patricia Brebner
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT No.6907
State of California
County of Change
On December 18, 2001 before me, Alexis H.Bryan,Notary Public
DATE NAME,TITLE OF OFFICER-E.G.,"JANE DOE,NOTARY PUBLIC"
personally appeared Patricia Brebner
NAME(S)OF SIGNER(S)
personally known to me-OR- El proved to me on the basis of satisfactory evidence to be the person(s)
whose name(s) is/are subscribed to the within instrument and
acknowledged to me that he/She/they executed the Same in
his/her/their authorized capacity(ies), and that by hislherltheir
signature(s) on the instrument the person(s), or the entity upon
behalf of which the person(s) acted, executed the instrument.
SAL S Hul�YA-
rC'w'ri"t# 5?La1`. ''a:+tt Z WITNESS my handandofficialseal. *a
`d Nct Y.3Gxi!C 3 cffi C3'#fr'
y
+` SIGNATURE OF NQ's RY
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document and
could prevent fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT
INDIVIDUAL
[� CORPORATE OFFICER
TITLE OR TYPE OF DOCUMENT
TITLES)
Q
PARTNER(S) LIMITED
GENERAL
ATTORNEY-IN-FACT H
TRUSTEE(S)
[1 GUARDIAN/CONSERVATOR NUMBER OF PAGES
OTHER:
SIGNER IS REPRESENTING: DATE OF DOCUMENT
NAME OF PERSON(S)OR ENTrrY(IES)
SIGNER($)OTHER THAN NAMED ABOVE
S-40871GEEF 2198 01893 NATIONAL NOTARY ASSOCIATION-8236 Remmet Ave.,P.O.Bebe 7184•Cam Park,CA 91309-7184
FIREMAN'S FUND INSURANCE COMPANY
NA`I ONAL SURIPTY CORPORATION ASSOCIATED INDEMNM CORPORATION
THE AMERICAN INSURANCE COMPANY AMERICAN AUrOMOBELE INSURANCE COMPANY
GENERAL POWER OF AVORNEY
KNOW ALL MEN BY THESE PRESENTS., That FIREMAN'S FUND INSURANCE COMPANY, a California corporation, NATIONAL
SURETY CORPORATION,an Illinois corporation,THE AMERICAN INSURANCE COMPANY,a Now Jersey corporation redomesticated in
Nebraska, ASSOCIATED INDEMiM"Y CORPORATION, a California corporation, and AMERICAN AUTOMOBILE INSURANCE
COMPANY,a Missouri corporation,(herein collectively called"the Companies")does each hereby appoint Patricia Bre bne r
of Costa Mesa, CA
their true and lawful Attorneys)-in-Fact, with full power of authority hereby conferred in their name, place and stead, to execute, seal,
acknowledge and deliver any and all bonds,undertakings,recognizances or other written obligations in the nature thereof------------
and to bind the Companies thereby as fully and to the same extent as if such bonds were signed by the Resident,sealed with the corporate seals of the
Companies and duly attested by the Companies'Secretary,hereby ratifying and confirming all that the said Attorney(s)-in-Fad may do in the premises.
This power of attorney is granted under and by the authority of Article VII of the By-laws of each of the Companies which provisions are now
in full force and effect.
This power of attorney is signed and sealed under the authority of the following Resolutiog adopted by the Board of Dimctors of each of the
Companies at a meeting duly called and held,or by written consent,on the 11th day of March, 1995,and said Resolution has not been amended
or repealed:
"RESOLVED,that the signature of any Vice-1 idem,Assistant Secretary.and Resident Assistant Secretary of the Companies,
and the seal of the Companies may be affixed or printed on any power of attorney,on any revocation of any power of attorney.
or on any certificate relating thereto,by facsimile,and any power of attorney,any revocation of any power of attorney,or
certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Companies."
IN WITNESS WTIERBOF,the Companies have caused these presents to be sigby their Vice-President;-and their corporate seals to be hereunto
affixed this 3 0 day of January 2,01-ed .
FUMMAN"S FUND INSURANCE COMPANY
NATIONAL SURETY CORP'ORAnON
s*L3
stTHE AMERICAN INSURANCE COMPANY
�.x
. _._; 1 ASSOCLATED INDEMNITY CORPORATIONt` �'' ;` .,t• � *'ker CU xaz• �`� '�t` 'svt°� AIERIC [3'TOhIOBUE INSURANCE CO�►.�PANY
�
STATE OF CALIFORNIA SS. By
COUNTY OF MARIN vice-r�tt��nc
on this 30 day of January 2 001,before mo personally came Dunn R. Kal.beclE
to me known,who,being by me duly sworn,did depose and say:that he is a Vice-President of each company,described in and which executed
the above instrument;that he knows the seals of the said Companies,that the seals affixed to the said instrument are such company seals;that
they were so affixed by order of the Board of Directors of said companies and that he signed his name thereto by like order.
iN WI'T'NESS WHEREOF,I have hereunto set my hand and affixed my official seal,the day and year herein first above written.
KRISTIN A.CA�Zt?U
test.*tie .�
ii NOTARY PUSIC— i.IFO RKk
L MANN CORN N 0 �
Aly Comm 4N 20.20M
• N
STATE OF CALIFORNIA I SS, CERnFICA:TE 0111 t"j
COUNTY OF MARIN
I, die undersigned, Resident Assistant Secretary of each company, DO HEREBY CERTIFY that the foregoing and attached POWER OF
Al TORNEY remains in full farce and has not been revoked;and furthermore that Article VII of the By-laws of each company,and the Resolution
of the Board of Directors,stat forth in the Power of Attorney,are now in force.
Signed and sealed at the County of Marin. Dated the 18th day of ➢e c emb e r , 2001
asti�tar a'�N'7i t , hY
...... ekar a xc c�' tara,'�' Resident Assistant S
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ROAD TMPR VEMEI`2 f ACRES #
Developer: Mndtm=BLC Effective Date: ¢
Development: LZA 1108 LgrQss-efc SUB 7976 Completion Period: l year
Road: anger Canvgn Road North _ DD-VELQPE—:WINDEMERE BLC LAND COMPANY LLC,
A California limited liability company
THESE SIGNATURES ATTEST TO THE PARTIES'AGREEMENT HERETO: By:LEN-OBS Windemere,LLC,
A Delaware limited liability company
Ct3AlTRA QQA 99th" __ Managing Member
_ _ By:f ennar Homes of California,Inc.,
Maurice M.Shiu,Public Works Director
anagfornia corporatio
(yyy M
't Y
By: +ata +._, ti {aitwc)
SA
i (Prk name&bite)
\.•
Peterson Vice President
R90MMENDED FOR AI k&Q-V-&
By:
Engineering sere i ` ion {pricesaxre eiste)
Don Larson Chief Financial Officer
FORM APPROVED: Victor J.Westman,County Counsel -
(NOTE: All signanaea to be acknowledged.if Subdivider is incorporated,siguaum nwt
conform vlth the designated representative soups pursuant to Carpo adm Code s313_)
1. EAR=&BATE:Effective on the above date,the County ofContra Costa,California,hereinafter called°amu tri"and the above tnrstaoned Dqve
mutually promise and awe as follows concerning this development:
2. zMV I ITS, Developer 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 plane for this developmietlt as reviewed and on
Me with the Cara Costa County Public Works Department and in conformance with the Contra.Costa County Ordinance Code(including future amendments therew).
Developer shall completes said work and improvements (hervi na€ler called"work")within the above completion period from date hereof in a good
workmanlike manner,in accordance with accepted construction practices and in a manner equal or superior to the requirement ofthe County Ordinance Code and
rulings rtmWe thereunder,and where there is a conflict between the improvement plans and the County Ordinance Code,the stricter requirenments shall govern.
3. TMPROYM M SECURITY. Upon executing this Agreement,the Developer shall,pursuant to the County Ordinance Code,provide as security to the
County.
A. ger Performance Grantees $I l.000.00 cash,plus additional security,in the amount of$ jQ24,90t).00 which together total one hundred
percent(It10°/u)of the estimated cost ofd work. Such additional security is presented in the form of.
Cash,certified check or cashiers check.
Acceptable corporate surety bond.
_ Acceptable irrevocable letter of credit
With this security,the.Developer 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$553.000.00,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 band.
Acceptable irrevocable letter of credit
With this sccurxty,the Developer guarantees payment to the contractor,to his subcontractors,and to persons renting equipment or fumisshing labor or
materials to them or to the Developer.Upon acceptance of work as complete by the Board of Supervisors and upon request of time Developer,the amount securities
may be reduced in accordance with 594-4.406 and 534-4.408 of the Ordinance Code.
4. 9i J?RA1 E.AM__MME AlV'1'Y OE-W-QR=- Developer guarantees that said work shall be free from defects in rrmaterW or workmanship and shall
perform satisfactorily for a period ofone-year from and after the Hoard of Supervisors accepts the work as complete in accordance with Article 96-4.6,"Acceptance,"
of the Ordinance Cade. Developer agrees to correct,repair,or replace,at his expense,any defects in said worse.
The guarantee period does not apply to road improvements for private roads which are not to be accepted into the:County road system.
5. PLANT Ec't'ai.rMENT Wary1nK Developer agrees to perform establishment work for landscaping installed under this agreement. Said plant establishment
work shall consist of adequately watering plants,replacing unsuitable plants,doing weed,rodent and other pest control and other work determined by the Public Works
Department to be necessary to insure establishment of plants. Said plant establishment work shall be performed for a period of one-year from and afterthe Board ofSupervisors
accepts the work as complete.
& I,�v PROVEIvIBNT FLAN WARREANTY. Developer war ants the improvement plans for the work are adequate to accomplish the work as promised in Section 2 and
as required by the Conditions of Approval for the development. If,at any time before the Board of Supervisors accepts the work as complete or during the one-year guarantee
period,said improvement plans prove to be inadequate in any respect,Developer shall make whatever changes are necessary to accomplish the work as promised.
7. NOWA VER BY CCUN'l'Y. inspection of the work and/or materials,or approval of work and/or materials or statement by any officer,agent or employee of the
County indicating the work or any part thereof complies with the requirements of this Agreement,or acceptance of the whole or any part of said work and/or materials,or
payments,therefor,or any combination or all of these acts,shall not relieve the Developer of his obligation to fulfill this agreement as prescribed;nor shall the County be thereby
be stopped from bringing any action for damages arising from the failure to comply with any of the terms and conditions hereof:
8. IIt DEQ N Y: Developer shall hold harmless and indemnify the indemnitees from the liabilities as defined in this section:
A. The indemnities benefitted and protected by this promise are the County,and its special district,elective and appointive boards,commissions,officers,
agents,and employees.
B. The liabilities,protected against are any liability or claim for damage of any kind allegedly suffered,incurred or threatened because of actions defined
below,and including personal injury,death,property damage,inverse condemnation,or any combination of these,and regardless of whether or not such liability,claim or
damage was unforeseeable at any time before the County reviewed said improvement plans or accepted the work as complete,and including thedefense ofany suit(s),action(s),
or other proceeding(s)concerning said liabilities and claims.
C. The AgliQns mgjast liabili are any actor omission(negligent or non-negligent)in connection with the matters covered by this Agreement and attributable
to the Developer,contractor,subcontractor,or any officer,agent,or employee of one or more of them;
D. Non-Conditions:The promise and agreement in this section are not conditioned or dependent an whether or not any Indemnitee has preparod.supphed,or
approved any plan(s)or specification(s)in connection with this work,or has insurance or other indemnification covering any of these matters,or that the alleged damage resulted
partly form any negligent or willful misconduct of any Indemnity.
B. 1. Windemere BL.0 Land Company LLC('TLC')shall indemnify,defend and protect Contra Costa County("County'")and the Contra Costa County
Flood Control and Water Conservation District(collectively,"District'I against,and hold County and District harmless from,any and all claims,costs,losses,liabilities,damages
or other expenses(including attorneys fees and expenses),to the fullest extent not prohibited by applicable law,arising out of or alleged to arise out of BL,C's activities under
Section 5(c)of that certain`Supplement to Cooperation Agreement,"dated June,2000,by and between BL.0 and Shapeli Industries,Inc.("Shapeli')including,without
limitation,any claim,cost,loss,liability,damage or other expense arising out of any action or other proceeding brought by Shapell against County ortistrict in connection with
any act,approval or other requirement of County or District in connection with BL:C's activities under the aforementioned Supplement to Cooperation Agreement.
2. BLC's obligations under Section I above shall exist regardless of concurrent negligence or willful misconduct on the part of the County or District or
any other person;provided,however,that BIC shall not be required to indemnify,protect,defend or hold County or District harmless to the extent anyclaims,lasses„liabilities,
damages or other expenses are attributable to the negligence or willful misconduct of County or District in maintaining or repairing improvements that have been offered for
dedication to and accepted byCounty or District for maintenance.The obligations of BL:C contained in the Agreement shall survive termination of the Cooperation Agreement
and shall survive the dedication and acceptance of improvements by County or District,
9. MM: Developer shall pay when due,all the costs of the work,including inspections thereof and relocating existing utilities required thereby.
10. MO - I;KFO tvl Nly}10 L=:If Developer fails to complete the work within the time specified in this Agreement,and subsequent extensions,or fails to
maintain the work,the County may proceed to complete and/or maintain the work by contract or otherwise,and Developer agrees to pay all costs and charges incurred by the
County(including,but not limited to: engineering,inspection,surveys,contract,overhead,etc.)immediately upon demand.
Developer hereby consents to entry on the development property by the County and its forces,including contractors,in the event the County proceeds to complete
and/or maintain the work
once action is taken by County to complete or maintain the work,Developer agrees to payall costs incurred by the County,even if Developer subsequently completes
the work.
Should County sue to compel performance under this Agreement or to recover costs incurred in completing or maintaining the work,Developer agrees to pay all
attorneys fees,and all other expenses of litigation incurred by County in connection therewith,even if Developer subsequently proceeds to complete the work.
11. INCOILp0&&1of MMEXA!J0N. if,before the Board of Supervisors accepts the work as complete,the development is included in territory incorporated as a
city or is annexed to an existing city,the County's rights under this agreement and/or any deposit,bond,or letter of credit securing said rights shall be transferred to the new or
annexing city. Such city shall have all the rights of a third party beneficiary against Developer,who shall fulfill all the terms of this agreement as though Developer had
contracted with the city originally.
12. CONSIDERATION In consideration hereof:
(Check applicable section(s))
County shall allow Developer to obtain building permits for said development,assuming it fully complies with other applicable regulations.
County agrees to accept the road(s)into the County-maintained road system,after the improvements are complete.
Other(requires County Counsel approval
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
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personally appeared
Name's)of Signar(8)
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Whose name(s)?s/are subscribed to the within instrument
and acknowledged to me that heis4�e/they executed the
same in 444w/their authorized capacity(ies),and that by
Y" DEBRA AW fl* his it/their signature(s)on the instrument theperson(s), �
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Comm,EXP.JULY 16,2305-'
WITNESS my id and official s
Signature of Notary Public
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12 Thou t•the rrfo,matic:below is not required b taw it may prove valuable to persons relying on the document and could prevent
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fraudulent ramoval and reattachment of this form to another document.
Description of Attached Document
Title or Type of document: :
Document Date: Number of Pages:
Signer(s) Other Than Named Above:
Cspecity(ies) Claimed by Signer(s) 5
Signer's Name:
g Signer's Name:
Individual C Individual
❑ Corporate Officer ❑ Corporate Officer
Title(s): Title(s):
❑ Partner---❑ Limited ❑ General ❑ Partner p-❑ Limited ❑General
❑ Attorne y-�1n-f=act
❑ Attorney-in-f`act
❑ Trustee ❑ Trustee
❑ Guardian or Conservator ' 11 Guardian or Conservator
❑ Other: :op of ihu b he e I❑ Other: Tor of thumb here
Signer Is Representing: Signer is Representing:
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0 1995 National Notary Association•8236 R ntrnet Ave.,P.O.Box 7184•Carsoga Park:CA 91309-71.84 Prod.No.5907 Reorder:CaR TM-Free 1,800.876-6827