HomeMy WebLinkAboutRESOLUTIONS - 01012002 - 2002-303 0,1,e
THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Adopted this Resolution on May 14, 2002 by the following vote:
AYES: SUPERVISORS GERBER, UILK-MA, DESAULNIER, GLOVER,, 'AND GIOIA
NOES: NONE
ABSENT: NONE
ABSTAIN: NONE
RESOLUTION NO.2002/ 303
SUBJECT: Approval of a Substitute Subdivision Agreement for warranty period, Subdivision
$136, Clyde area. (District IV)
The following document was presented for Board approval this date:
A substitute Subdivision Agreement for the warranty period with Discovery Builders Inc.,
subdivider, whereby said subdivider agrees to warranty all improvements as required in said
Subdivision Agreement.
Said document was accompanied by the following:
Security to guarantee the warranty of public road and drainage improvements as required by
Title 9 of the County Ordinance Code, as follows:
a. Cash deposit (Auditor's Deposit Permit No. 385631, dated April 30, 2002 in the
amount of$2,800.00,made by Discovery Builders Inc.
b. Additional security in the form of a corporate surety bond dated May 1, 2002, and
issued by Travelers Casualty and Surety Company of America (Bond No.
103667675)with Discovery Builders Inc. as principal,in the amount of$39,845.00
for warranty.
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G:\GrpData\EngSvc\BO\2002\5-14-02\Sub 8136 BO-24.doc
Originator: Public Works(ES) I hereby certify that this is a true and correct copy of an action taken
Contact., Rich Lierly(313-2348) and entered on the minutes of the Board of Supervisors on the date
cc, Public Works -Accounting shown.
-T.Bell,Construction Div. May 4, O O
-P.Edwards,Eng.Svc. ATTESTED:
Discovery Builders Inc. JOHN SWEETEN,Clerk of the Board of Supervisors and
1820 Arnold Industrial Way,Suite N,Concord,CA 94520 County Administrator
Travelers Casualty&Surety Co.of America
350 California St.,Suite 2020,San Francisco,CA 94104 r
American Building&Development,Inc. By Deputy
3125 Clayton Road,Concord,CA 94519
Developers Insurance Co.
17780 Fitch,Suite 200,Irvine,CA 92623
N.Insurance Brokers,Attn:Bob Halpin
590 Lennon Lane,Suite 160,Walnut Creek,CA 94598
David Zeiglar
3143 Clayton Road,Concord,CA 94520
RESOLUTION NO.2002/ 303
SUBJECT: Approval of a Substitute Subdivision Agreement for warranty period, Subdivision
8136, Clyde area. (District IV)
DATE: May 14, 2002
PAGE: 2
All deposit permits are on file with the Public Works Department.
NOW THEREFORE BE IT RESOLVED that said substitute Subdivision Agreement is
APPROVED.
BE IT FURTHER RESOLVED that the Subdivision Agreement with David Zeigler, as
approved by the Board on August 1, 2000, is TERMINATED, the improvement security bond(s)
with Developers Insurance Company are EXONERATED and the Public Works Director is
AUTHORIZED to refund the cash deposit (Auditor's Deposit Permit No. 351925, dated June 20,
2000)in the amount of$2,800.00,plus interest in accordance with Government Code Section 53079,
if appropriate,to American Building and Development Inc.
RESOLUTION NO. 20021303
SUBDIVISION AGREEMENT
FOR
IMPROVEMENT WARRANTY
(After Construction is Complete)
(Government Code§66462 and§66463)
(SO Subdivisibn: ts:>Effective Date: _ May 14 2002
(SO Subdivider: ���[` ., c�Ci'u - (w)Maintenance Period: I year or until released by Board
of Supervisors which ever is greater.
Deposits:
A. (cash) S ,-72.,
B. (bonds,et+.
1. (faithful performance&maintenance)$
2. (payment)
I, PARTIES&DATE. Effective on the above date,the County of Contra Costa,California,hereinafter called"County
and the above-maned,Subdivider,mutually promise and agree as follows concerning this subdivision:
2. IMFROVEMhNT WARRANTY. Subdivider warrants that the road and street improvements, bract drainage, street
signs, and all other public improvements were constructed, installed and completed in this'subdivision in a manner equal or
superior to the requirements of the county Ordinance Code,'Title 9.
3. GUA_RAbITEF,�&MAR3T� . Subdivider guarantees that the aforesaid subdivision improvements are and will
be free from defects and will perform satisfactorily in accordance with County Ordinance Code; and he shall maintain the
improvements for one-year after the date of this agreement against any defective workmanship or materials or any
unsatisfactory performance.
4. O_)Th= SECt R-. DEPOSIT& BONDS. Upon executing this agreement, Subdivider shall deposit as
security with the County:
A. Qj&. $1,000 cash or 1%of the estimated cost of the improvements,whichever is more;together with
B. Bond.etc.: (I Faithful performance) additional security totaling 15% of the cost of the estimated
improvements less the cash deposit in the form of a cash deposit, jg=gble ir6quMWt of _*_l or an acceptable
corporate surety bond, guaranteeing his faithful performance of this agreement and maintenance of the work for one-
year after the date of this agreement against any defective workmanship or materials or any unsatisfactory performance;
p us(2 payment for labor and materials)another such additional security in at least the above-Vecified amount,which
is 50°10 of the estimated':cast of the aforementioned improvements, securing payment to the contractor, to his
subcontractors, and to persons renting equipment or fiursushing labor or materials to tlim-or to the subdivider. Said
payment bond to become null and void six months after the ggnRletion of improvements.
5. NQ WAIVER BY CO>UIV'1"Y. Inspection of the improvements and/or materials, or approval of,improvements and/or
materials inspected,or statement by any officer,agent or employee of the County indicating that the improvements or any part
thereof comply with the requirements of tliis agreement, or acceptance of the whole or any part of said improvements and/or
materials, or payments therefor, or any combination or all of these acts, shall not relieve the Subdivider 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 terns and conditions hereof:
6. INDEMNITY. Subdivider shall hold harmless and indemnify the indemnities from the liabilities as defined in this
section:
I
A. The indemnities benefited and protected by this promise are the County, and its special districts, 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 approved the subdivision map or accepted the improvements as
completed,and including the defense of any suit(s),actions(s),or other proceedings(s)concerning these;
C. The actions causing liability are any act or omission (negligent or non-negligent) in connection with the
matters covered by this agreement and attributable to the Subdivider, 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 on whether or
not any Indemnity has prepared, supplied, or approved any plan(s) or specifications(s) in connection with the
improvements-or subdivision,or has insurance or other indemnification covering any of these matters.
7. COSTS. Subdivider shall pay or have paid when due all the costs of the work, including inspection thereof and
relocating existing utilities required thereby.
8. NO AND COSTS. If Subdivider fails to maintain the work and improvements during the time
specified in this agreement,County pay proceed to maintain them by contract or otherwise, and Subdivider shall pay the costs
and charges therefore immediately upon demand. If County sues to compel performance of this agreement or recover
engineering costs and the cost of maintaining the improvements, subdivider shall pay all reasonable attorneys' fees, costs of
suit,and all other expenses of litigation incurred by County in connection therewith.
9. ASSIGNMENT. If before the completion of the maintenance period the subdivision is annexed to a city, the County
may assign to that city the County's rights under this agreement and any deposit or bond securing them.
10. T ABQR & MATERIALS WAMAM. Subdivider further warrants that.the claims and liens of all persons,
contractors, and subcontractors furnishing labor or materials for the installation of said improvements in the subdivision have
been satisfied. The subdivider agree to satisfy any valid claims or liens of labor and materialmen as to the said improvements
and subdivision appearing hereafter upon demand by the County.
II.- RECORD MAP. In consideration hereof,County shall allow Subdivider to file and record said subdivision map, and
recognizes this subdivision as on complying with State laws and County ordinances.
CONTRA COSTA COUNTY: SUBDIVIDER:
Mau ce `
j- Vie} Public Works Director Di scov.ery Buil ders, -Inc.
4021 Port Chicago Hwy.
Concord,. CA QA520
9L-
By: .NA4 AAAA- c >
REQQMMENDED R APPROV : Albert D. Seeno III - President
By:
<�
(Oatnarw"k) Kathleen M. ckard, Secretary
Ff7RMA D15RO Victor J.Westman,County Counsel
Note to Subdivider: Attach acknowledgment form below
and affix corporate seal.
RLMW
C,-.\o1pbata '�Svc\For=\AG WORMAG-33.doc
Rev.February 1.1499
%.VVN I T %Jr 11-"411SJ°t t..Va"11A
DEPOSIT PERMIT;
-i— OFFICE OF COUNTY ALOITOP-CONTROLLER
�REA+SUREIt: MARTINEZ,CAUFORNIA
t' CIi ED FROM
ORGANIZATION NUMBER
:fit , .( .1✓ GWL
. ' .
` (Far Cosh Collection Procedures see County Adrrtinistrator's Bulletin 105:)
x.
DESCRIPTION FUND/ORG' ACCT. TASK OPTION ACTIVITY AMOUNT
t Y`
77,
ODD loc
,' '{ tF 4�tl.ol 1 ♦ t . . . . _ ���i f: 3�� 7 Y 1 d �i��� �t 8i�
CALWORNIA ALL-PURPOSE ACKNOWLEDGEMENT
State of I OPTIONAL SECTION
Coun of CAPACITY CLAIMED BY SIGNER
.✓ Though statute does not require the Notary to fill in
On ATB before txk, a DO UMBUC• the data below,doing so may prove Invaluable to
personally appeared parsons relying on the document.
l 51DNIDUAL
CORPORATE CSF ICER{S}
personally known to me-Olt-U proved to me on the beefs of satisfactory evidence to ,� i�
ba mm t
the Con{s}whose narru{s}i e> :I l
subsm to the within instrummrt d
acknowledged to me he/sh a executed D PARTNER(S) n LIMITED
the same in hi uthori 0 GENERAL `
capacity{ias},an by hislh Cir U ATTORNEY-IN-FACT
CAROLYN DIANNE WOIFORD the entity
u on thealfofwhic conn or D TRUSTEE(S)
COMM. 1278158 � the entity upon behalf tr which the persons} U GUARDIAN/CONSERVATOR
ectad.executed the instrument.
NOTARY PUBLIC-CALIFORNIA it OTHER:
.. - CONTRA C"STA COUNTY ..
l My Comm.Expires Sept.24,20041 WITNESS m hand and offic" 1 al,
SIGNER IS REPRESENTING:(NATE OF PFMON(S)OIL M7n rY(=))
OPTIONAL SECTION
THIS CERTIFICATE MUST BE ATTACHED Title or Type of Uocu r "
TO THE DOCUMENT AT RIGHT. Number of Pages
Though the data below is not required by law,it may prove valuable Date of Document —�
to persons relying on the document and could prevent fraudulent Signer(s)Other Than Named Above
re-attachment of this form
Il SSTRUCT IWE TO NOSY
The following information is provided in an effort to expedite processing of the documents.
Signatures required on documents must comply with the following to be acceptable to Contra Costa County.
1. FOR ALL 50VAZEM -The name and interest of the signer should be typed or printed BENEATH the signature. The
name must be signed exactly as it is typed or printed.
II. SI9hjAjj= -The'tiame must be signed exactly as it is printed or typed. The signer's interest in the .
property must be stated.
in. (&41 ' FOA PAR S- Sigm,ng party must be either a general partner or be authorized in writing to have
e authority to sign for bind the.partnership,
IV. SIGNAn=S FOR CORPORATIONS
Documents should a signs y two o cars,one from each of the following two groups:
GROUP 1. Nahair of the Board
(b}The President
(c Any Vice-President
GROUP 2. f.1 The Secretary
An Assistant Secretary
c The Chief Financial Officer
The Assistant Treasurer
If signatures of officers from each of the above two groups do not appear on the instrument, a certified copy of a resolution of the
Board of Directors authorizing the persoxr signing the instrument to execute instruments of the type in question is required"A currently
valid power of attorney,notarized,will since.
Notarization of only one corporate signature or signatures from only oneup,must contain the following phrase:
".-and acknowledged to me that such corporation executed the within instrument pursuant to its by-laws or a resolution of its Board of
Directors."
JQMW
4vs4`satA l3ATAu3egDualBngsr To=\WORDFaR&SIAIr.KWOSSTlor XY.eac
000649-9665 1831000: G1092668, 18,242.41, SUB 8002 Plan Check Fees,
Shapell Industries of Northern California, 100 N. Milpitas Blvd., PO Bax
361165+, Milpitas, CA 95035
000649-9665 / 831000: G1092679, $35,279.63, SUB 7984 (Task 81C)
Landscape Improvement review, Shaper Industries of Northern California,
100 N. Milpitas Blvd., PO Box 361169; Milpitas, CA 95035
000649-9665 / 831000: G1092684, $36,159.00, SUB 8646 Plan Check Fee,
Western %cif is Housing, 400 N. 'Continental Blvd., Suite 100, El Segundo, CA
90245
+z:
819800-0800: G1092670, $2,800,00, SUB 8136 Cash Bond (Security
Deposit), Discovery- Builders, Inc., ATTN: Salvatore Evola, 1820 Arnold
Industrial Way, Suite N, Concord, CA 94520
Subdivision 8136
Bond No.: 103667675
Effective date of Bond: May 1, 2002
IMPROVEMENT SECURITY BOND
FOR SUBDIVISION AGREEMENT
(Performance, Guarantee and Payment)
(California Government Code§§66499- 66499.10)
1. RECITAL OF SUBDIVISION AGREEMENT: The developer (principal) has executed a subdivision agreement
with the County of Contra Costa to install and pay for street, drainage and ether improvements in
Subdivision 8136 as specified in the subdivision agreement and to complete said work within
the time specified for completion in the subdivision agreement, all in accordance with State and local laws
and rulings thereunder in order to satisfy,conditions for filing of a final map or parcel map for said
subdivision.
2. OBLIGATION: Discovery Builders,Inc. as principal and
Travelers Casualty and Suretv Company of America, a corporation organized and existing under the
laws of the State of Connecticut and authorized to transact surety
business in California, as surety, hereby jointly and severally bind ourselves, our heirs, executors,
administrators, successors and assigns to the County of Contra Costa, California to pay as follows:
A. Performance and Guarantee: Thirty-nine Thousand Eight Hundred Forty-Five and 00/100
Dollars($ 39,845.00 for Contra Costa County or any city assignee under
the above County Subdivision Agreement.
B. Payment: _ Thirty-nine Thousand Eiebt Hundred Forty-Five and 00/100 Dollars
($ 39,845.00 } to secure the claims to which reference is made in Title XV
(commencing with Section 3082) of Fart 4 of Division III of the Civil Code of the State of
California.
3. CONDITION:
A. The Condition of this obligation as to Section(2.A.) above is such that if the above bonded principal,or
principal's heirs, executors, administrators, successors or assigns, shall in all things stand to and abide
by and well and truly keep and perform the 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 performed at the
time and in the manner therein specified and in all respects according to their true intent and meaning
and shall indemnify and save harmless the County of Contra.Costa(or city assignee) its officers, agents
and employees, as therein stipulated, then this obligation shall become null and void; otherwise it shall
be and remain in full force and effect.
As part of the obligation secured hereby and in addition to th- face amount specified therefore, there
shall be included reasonable costs, expenses and fees, including reasonable attorney's fees, incurred by
the County of Contra Costa(or city assignee)=n successfully. enforcing such obligation, all to be taxed
as costs and included in any judgement rendered.
l
B. The condition of this obligation, as to Section (2.B.) above, is such that said principal and the
undersigned, as corporate surety, are held firmly bound unto the County of Contra Costa and all
contractors, subcontractors, laborers, material men and other persons employed in the performance
of the aforesaid subdivision agreement and referred to in the aforesaid Civil Code, for materials
furnished, labor of any kind, or for amounts due under the Unemployment Insurance Act with
respect to such work or labor and that said surety will pay the same in an amount not exceeding 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 costs, expenses and fees, including reasonable attorney's fees,
incurred by the County of Contra Costa (or city assignee) in successfully enforcing such obligation,
to be awarded and fixed by the court, all to be taxed as costs and to be included in the judgement
therein rendered.
It is hereby expressly stipulated and'agreed that this bond shall inure to the benefit of any and all
persons, companies and corporations entitled to file claims under Title 15 (commencing with Section
3082)of Part 4 of Division 3 of the Civil Code, so as to give a right of action to them or their assigns
in any suit brought upon this bond.
Should the work under conditions of this bond be fully performed, then this obligation shall become
null and void; otherwise it shall be and remain in full force and effect.
C. No alteration of said subdivision agreement or any plan or specification of said work agreed to by
the principal and the County of Contra Costa (or city assignee) shall relieve the surety from liability
on this bond; and consent is hereby given to make such alteration without further notice to or
consent by the surety; and the surety hereby waives the provisions of California Civil Code Section
2819 and holds itself bound without regard to and independently of any action against the principal
whenever taken.
Re: Park Place One-year Public Improvement Warranty
SIGNED AND SEALED on April 2.2402
PRINCIPAL:.Disc 3VERY BUILDERS.INC. SURETY: Tuvswms CumTy mw SuRm Comma op Aanim
Address: 4021_Port Chicano Hirhway Address: 350 California Streets Shite 2020
City: Concord CA Zi 94524 City: San Fraficisco Zip:M104
By:__— By:
Print Name: ALBERT D. 8EEN0 III Print Name: Shirley or -Bassel
Title: PRESIDENT Title: Attorney-in-fact
Mmw:lap
GAGrpD&%\ngSvc\Forms\BN WORMBN-12.doc
Rev.November 28,2050
l
TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA
TRAVELERS CASUALTY AND SURETY COMPANY
FARMINGTON CASUALTY COMPANY
Hartford,Connecticut 06183-9062
POWER OF ATTORNEY AND CERTIFICATE OF AUTHORITY OF ATTORNEYS)-IN-FACT
KNOW ALL PERSONS BY THESE PRESENTS, THAT TRAVELERS CASUALTY AND SURETY COMPANY OF
AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY COMPANY,
corporations duly organized under the laws of the State of Connecticut, and having their principal offices in the City of Hartford,
County of Hartford, State of Connecticut, (hereinafter the "Companies") hath made, constituted and appointed, and do by these
presents make, constitute and appoint: R. Scott Daugherty, G. Sue Dituri, Shirley York-Bassel, of San Francisco, California,
their true and lawful Attorney(s)-in-Fact, with full power and authority hereby conferred to sign, execute and acknowledge, at any
place within the United States; the following instrument(s): by his/her sole signature and act, any and all bonds, recognizances,
contracts of indemnity,and other writings obligatory in the nature of a bond, recognizance,or conditional undertaking and any and
all consents incident thereto and to bind the Companies, thereby as fully and to the same extent as if the same were signed by the
duly authorized officers of the Companies, and all the acts of said Attorneys)-in-Fact, pursuant to the authority herein given, are
hereby ratified and confirmed.
This appointment is made under and by authority of the following Standing Resolutions of said Companies, which Resolutions are
now in full force and effect:
VOTED: That the Chairman,the President,any Vice Chairman,any Executive Vice President,any Senior Vice President,any Vice President,any
Second Vice President,the Treasurer,any Assistant Treasurer,the Corporate Secretary or any Assistant Secretary may appoint Attorneys-in-Fact
and Agents to act for and on behalf of the company and may give such appointee such authority as his or her certificate of authority may prescribe
to sign with the Company's name and seal with the Company's seal bonds,recognizances,contracts of indemnity,and other writings obligatory in
the nature of a bond,recognizance,or conditional undertaking,and any of said officers or the Board of Directors at any time may remove any such
appointee and revoke the power given him or her.
VOTED: That the Chairman,the President,any Vice Chairman,any Executive Vice President, any Senior Vice President or any Vice President
may delegate all or any part of the foregoing authority to one or more officers or employees of this Company,provided that each such delegation is
in writing and a copy thereof is filed in the office of the Secretary.
VOTED: That any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional
undertaking shall be valid and binding upon the Company when(a)signed by the President,any Vice Chairman,any Executive Vice President,any
Senior Vice President or any Vice President, any Second Vice President, the Treasurer, any Assistant Treasurer,the Corporate Secretary or any
Assistant Secretary and duly attested and sealed with the Company's seal by a Secretary or Assistant Secretary,or(b)duly executed(under seal,if
required)by one or more Attorneys-in `act and Agents pursuant to the power prescribed in his or her certificate or their certificates of authority or
by one or more Company officers pursuant to a written delegation of authority.
This Power of Attorney and Certificate of Authority is signed and sealed by facsimile (mechanical or printed) under and by
authority of the following Standing Resolution voted by the Boards of Directors of TRAVELERS CASUALTY AND SURETY
COMPANY OF AMERICA, TRAVELERS CASUALTY AND SURETY COMPANY and FARMINGTON CASUALTY
COMPANY,which Resolution is now in full force and effect:
VOTED: That the signature of each of the following officers: President, any Executive Vice President, any Senior Vice President, any Vice
President,any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any
power of attorney or to any certificate relating thereto appointing Resident Vice Presidents,Resident Assistant Secretaries or Attorneys-in-Fact for
purposes only of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof,and any such power of attorney
or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and
certified by such facsimile signature and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or
undertaking to which it is attached.
{11-00 standard)
CALIFORNIA ALL-PURPOSE ACKNOWLEDGEMENT
State of CALIFORNIA
County of ALAMEDA
On April 2, 2002, before me, MICHELE GLASKY, NOTARY PUBLIC personally
appeared SIBRLEY YORK-BASSEL.
XX persona known:to me—OR- ®proved to me on the basis of satisfactory
evidence to be the person whose name is
subscribed to the within instrument and
acknowledged to me that he/she/they
executed the same in his/her/their authorized
capacity , and that by his/her/their signature
.:_.��.. , .� on the instrument the person, or the entity
MICHELE GLASupon behalf of which the person acted,
0 COMM.#1224832
NOTA-,f PUBLIC-CALIFORNIA O executed the instrument.
'r At..A"�tFDA COUNTY 0
U
14CL114 W XPs JUNE 17,2003
✓ `f'"�"'"" '" WITNESS my hand and official seal.
Signature of No public
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
5,
State of California )
ss.
County of
t3
4n 4KtL�°` � , before me, ,
Date Name and Title of Mar(e.g.."Jane ,Notary Public")
personally appeared _ Am "C ,
Name(e)of Signer(s)
personally known to me )
❑ proved to me on the basis of satisfactory
--- evidence
to be the person($) whose name(05 islam,
subscribed to the within instrument and
acknowledged to me that he/s heAhey executed
the same in hislherAheir authorized
IGA81N capaclty(,ia f� ), and that by his/herUlre�ir
Commission#tom'ill signatureo)on the instrument the personal, or
NotcRyPubiic-C.10111111CIM1112 the entity upon behalf of which the personW
Contra Costo County acted, executed the instrument.
WComm. Dec31,20M
WITNESS my hand n )cial seal.
E :7
Place Notary Seel Above SjuA 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 fraudulent removal and reattachment of this form to another document.
Description of Attached Document
iI Title or Type of Document:
Document Date: Number of Pages:
Signer(s)other Than Named Above:
Capacity(les) Claimed by Signer
!° Signer's Name:
❑ Individual
i Ci Corporate Officer—Title(s): Top�#thumb Preys
❑ Partner--0 Limited ❑General )
❑ Attorney in Fact
❑ Trustee
` ❑ Guardian or Conservator
i
❑ Other: i
Signer Is Representing: }
0 1997 National Notary Association•9350 De Soto Ave.,Ro,Box 2402"Chatsworth,CA 91313-3402 Prod.No.$907 Reorder:Cali Toll-Free 1-800.878-5827