HomeMy WebLinkAboutRESOLUTIONS - 01012003 - 2003-231 THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Adopted this Resolution on April 15, 2003, by the following vote:
AYES: SUPERVISORS GIOIA, UILKEMA, GLOVER AND DESAULNIER
NOES: NONE
ABSENT: NONE
ABSTAIN: NONE DISTRICT III SEAT VACANT
RESOLUTION NO. 2003/ 231
SUBJECT: Approval of the Parcel Map and Subdivision Agreement for Subdivision MS 11-00,
being developed by John M. McKenzie,Alamo area. (District III)
The following documents were presented for Board approval this date:
I. Map
The parcel map of Subdivision MS 1100, property located in the Alamo area,
Supervisorial District III, said map having been certified by the proper officials.
II. Subdivision Agreement
A subdivision agreement with John M.McKenzie,principal,whereby said principal
agrees to complete all improvements as required in said subdivision agreement
within one year from the date of said agreement. Accompanying said subdivision
agreement is security guaranteeing completion of said improvements as follows:
JH:rm I hereby certify that this is a true and correct copy of an
G:\GrlsData\Engsvc\�BO\200344-15-031MS 11-00 Br-2l.doc action taken and entered on the minutes of the Board of
Contoriginator:Public e7iy( 13-2 Supervisors on the date shown.
Contact. Rich Liedy(313-2358)
cc: Public Works—M Bell,Construction
Current Planning,Community Development
T 2-15-04 ATTESTED: APRIL 15, 2003
John M.McKenzie
124 Castlewood Drive JOHN SWEETEN,Clerk of the Board of Supervisors and
Pleasanton,CA 94566 County Administrator
Gulf Insurance Company
Gordon J.Fischer
110 W.'A'Street,Ste.1805
San Diego,CA 92101
Allied Financial Services,Inc. ByDeputy
1833 Stephen Pinto
1833 Kofman Parkway ,
Alameda,CA 94502
RESOLUTION NO.2003/ 2 31
SUBJECT: Approval of the Parcel Map and Subdivision Agreement for Subdivision
MS 11-00,being developed by John M. McKenzie,Alamo area. (District III)
DATE: April 15, 2003
PAGE: 2
A. Cash Bond
Performance amount: $1,000.00
Auditor's Deposit Permit No. 402753 Date: March 27, 2003
Submitted by: John M.McKenzie
Tax ID Number: 566-42-2560
B. Surety Band
Bond Company: Gulf Insurance Company
Bond Number: BE2626275 Date: March 18, 2003
Performance Amount: $38,600.00
Labor&Materials Amount: $19,800.00
Principal: John M. McKenzie
III. Tax Letter
Letter from the County Tax Collector stating that there are no unpaid County taxes
heretofore levied on the property included in said map and that the 2002-2003 tax
lien has been paid in fall and the 2003-2004 tax lien,which became a lien on the first
day of January 2003, is estimated to be $8,800.00, with security guaranteeing
payment of said tax lien as follows:
• Tax Surety
Auditor's Deposit Permit No. 400450 Date: February 14, 2003
Amount: $8,800.00
Submitted by: Allied Financial Services, Inc.
NOW, THEREFORE, THE FOLLOWING IS RESOLVED:
1- That said subdivision, together with the provisions for its design and
improvement,is DETERMINED to be consistent with the County's general and
specific plans.
2. That said parcel map is APPROVED and this Board does not accept or reject on
behalf of the public any of the streets, paths, or easements shown thereon as
dedicated to public use.
3. That said subdivision agreement is also APPROVED.
All deposit permits are on file with the Public Works Department.
RESOLUTION NO. 2003/231
SUBDIVISION AGREE&Wrr
(Government Code W462 and S66463) f� /
Subdivision: MS 11-00 Effective Date:
Subdivider; John M McKenzie Completion Period:
JTHEStE SXG�N�vA�sTU/'RyES ATTEST TO THE PARTIES'AGREEMENT HERETO..
John M McKenzie
By. ,4, a v �e
,
RECQMUHNM
Bar
Division
irtiinptretii�a
Victor J.Wermian,
(NOM All dVishm to be is
WA1h- `
P Cole 8313.) °'x"P' '
i. paR c a DAIL EfibWve on the above darkthe of Contra C
t u%ally Pemm sad agora ar *Nx n ing*&, Y '° California, naftar calla! and the above-mentioned
fire 203MMU Subdivider 14 install oatain wed un (both panpry }, ts. g
andnatlight:,
as file Contra C1*1a Courr Pob&Woaks r�Ptt� rogtrirod in lite' pirtrtt Sar this tttbdit art as
fiuture tnnendrt�then to with the Contra Costa Courtly Ordinance Code(ino{uding
St"vidarsines oontpkie raid vm&=d called.
by Map act AwantmAt Code 3366414 and i VOwi ���the above wer.ie�Ptd lYotn dab hereof rt required
Pry and in a Mannar equat ar b the of the Cow tY in a goad aenlFkr manner,in vet saoopt
between the impwvetuad plans and the OWbnnw Code,Ate shicterty vordinance Code and ,aad'vvhero thtare it a oantlict
3' vprxt @tit Agmennrnt,lite Subdivider
• as b the Can:tty; .P�to Code 566439,and the County
total ane hand p (lgpyt, S 1,000.00 ,Pty additional Wcurity,in the amount of S 38 600.00 which iagether
Cott a t wank gueh additiaW wCurity is ptesatted in the fonds of+
X Cast►.Certified check of cashiers check.
Afteptablx
e ecrpmja wraty band.
letter ofcmdit
with this seenrhy,the
As Under
acceptance against any defective workmanship or ntasaruis or arty anastuf�tcca omttan� ntuuncr at the work for one year&&r its arrmpk tiarr.rtd
H. For p.,, l2& Security in the arnotrrrt of 1t19 000.80
security is the of + ,�which is fifty percent(SO%)of the ow of the work Such
Cath.Wtifred cheek,or oashk*Check
surety gond.
AcoTtabk irrevocable tetler of credit
or materials to thern b the Subdti*W.. it 1 payrnertt to the Corttnttstaor.to his suboonbracoors,and to persons ratting C4tuPatent or fLrnidting labor
C. Upon acceptance ofthe work as complete by the Board of Supervisors and upon request of dee Subdivider,the amount securities may be reduced
in accordance with S94-4.406 and 594.4408 of the Ordimw Code.
4. i towed tem WAAtte; aX OF Subdivider guarantees that said wale shall be free from defects in material or workrnansi ip and
sdsll peribrtn fro period ofone(I)year from and after the Board of Supervisors accepts the work as in accordance with Article 96- T
"Acceptance.",of the Onlinance Code. Subdivider agrees to corrock repair,or replace.at his expense.any defaces in said work.
The guarantee period does not apply to road improvements for ptivate roads which are not to beauto the County road syatrm,
�a
5. d&aEUMZAft=ML&bivxiwap=topedurmmtaMmhnmtwmtfor!mdinstalled under this agreement Said plant
cdabishnvxdwwkdwRoonsWafmiequdciyvAdmbgpknts,-qg i g unsuitable plants,doing wend,rodent andomer peat control arid,GOW work datemined
by the Public Works Degartmard to be accessuy to insure estab niiinent of plants. said plant establishment work shall be puf tied for a period o(Ing(1)
year from and sfbof
a flee
Supervisors accepts Ira work as complete.
b. Subdivider warrants the improv a m t 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 Subdivision. If,at any time bef n;the Board of3upervisorsaaoepta the work ore complete
or during dee one year guarantio paiocd,add improvement plans prove to be inadequate in any mpoc%Subdivider shall make whatever changes ace necessary
to aoeornplish the wok as promised.
7. M wArAM R1I t5[ItlN1'YImpaction ofthe wont and/or nuterials,or approval ofwork and/w materials or statement by any of aw,agent or
ampicyto of'the County indicating the work or any part thereof a mplias with the naquiraments of this Agreement or acceptance ofthe whole or arty part of
said vAxk and/or mtlesials,or payr>ses%dierd r,orrery or all ot`i m sets,alaiO not relieve the Subdivider anus oblirdon to&3611 this agrearned
as prescribed;nor shall the County be thereby be stopped from bringing any action for damages arising from the ficiluua to osnply with any of the to and
conditions hwecE
8. Subdivider shall!told harmless and indemnify the indemnitees faint the liabilities a2 defined in this station:
A. T'ba judamnifia benefitted and proecctod by this promise arc the County,and its special district.doctive and appointive boards.cosh
ofliorm agent,and 01101110yeall.
deSaad tioB. and am any Debility or claim for damage of any kind a Redly suffered.incurred or tturatened of actions
personal .death,property damage.inverse condemnation,or any o rubinatlon of hear.and ragudless ofwhether or not
such liability,Jahn or damsp was uriftmeabla at any time bc&v the County reviewed said improvement plans or accepted the work as oomplft and
including the ofarty sWa),action(s),orothar ptoetWing(s)concerning said liabilities and claims.
C. Y ha Sam Sumba J'jgbft are any a#or awn(nogligant or troy-negligent)ire connectim witlt dee mattes covered by this Agreement and
attributable to the Subdivider,eonha dor,subcontractor,or any otfbar,agent,or employee of one or more ofthem;
Dr. 'I'Isa P=nim and agrearnert in this section are not conditioned or dependent on whether or not nay k0amnitca has prepared,
ss»ippiied,orsdiproved any pkUW for speciliastitwn(s)in eonunedion wM this work or subdivision,or has uwxwm or odier indcautifiesdon covering any ofthexe
rrraAters,or Hast the alignd damage resulted partly neem arra+ritg5gent or wiltffd rniscanduct of any bsdensnity.
9. =TS Subdivider shall pay when due.all the pow of the work,including inspections thereof and relocxtirig existing utilities required thereby.
10. E j`R"YS Sabdividw sat and 0818bliah survey M04MMIX in with the fed map and to the salisSation of the County Road
before socepimm of any work as complete by the Hoard otSupervisots.
11. KQN-JMUDANAHQ ALM Q= If Subdivider fails to completz the work within the time specified in thised art runt
tc
w nxkmsti or fltils tri maintain the work.the County may l �
to p� maintain sintain the work by contactor odmrarw�bairdtvtdar to
PIYAII costs and charges incurred by the County(ncluding,but not iitnited to: a*ncring.inspection,surveys,contract,overhead,etc.)knee *upon
Subdividerherebyonnsentaloentryon the subdivision property by the County and its forces,inchufing contractors,in the event the County prcoceds
to compete an dlor maintain the work.
Once action is Ween by County to complete or maintain the work,Subdivider agrees to pay an amts incurred by the County,even if Subdivider
subsequently completes the work.
Should County sue to compel performmm under this Agreement or to recover costs incurred in completing or maintaining the work,Subdivider
Was to
cof"Pletaptayy aft s he fees.and all ether expanse of litigation incurred by County in connection therewith,even if Subdivider su tly proceeds m
wort
12• EQRA IG baton the Hoary!of Supervisors accepts the work as complete,the,,subdivision is included in territory
iDOWPOEMIXI=a cilyorisasuwoed ko an creating airy.the County's rights under this asmanent andlor any deposit,bask!.or inose of oradit accruing said rights
alai!be tis rte neve air y
Such city edamd have all the rights ofa,third parry beneficiary against subdividar,who shall fulfill all the terms
of this agrrecrrratet as though Subdivider had writruged with&a city originally.
13. RECORD UAP. In consideration hereof.County shall allow Subdivider to file and record the Final Map or Past Map for said Subdivision.
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
County of ss.
r
On 1 r .e�v 3, before me,
Data
-• e Name and TRWof r(e.g.,`ane Doe,Notary ublic")
personally appeared
Name(s)of Signer(s)
I'personaily known to me
E9 PF8Y8d te FM
IWMNautnutNutugiuwntlutui,t�ttttltigpNiiUMNlyttt to be the person(*) whose name(&) is/am
;�� � � ,� � subscribed to the within instrument and
"OMM 4 1250$14 acknowledged to me that he/ executed
yU1M'V"UeuC+CAU Of9NAt the same in his/NmWleimr authorized
A Aattun CUUNIVca acit
Myc:Mb EXP.An 21 21Dt P y(i*. and that by his/
signature(Al) on the instrument the person(#), or
the entity upon behalf of which the person(*)
acted, executed the instrument.
WITNESS my hand and official seal
j
Place Notary seal Above Signature oto blic
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
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
❑ Corporate Officer`Tttle(s): rop DI tnumb Hera
❑ Partner--❑Limited C]General
C] Attorney in Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other:
Signer is Representing:
O IM NoeofW Notary Asaacletbn+9380 De SWo Ave.,P.D.Box 2402+Chatsworth,CA 91313.2482+www.na0ana
k*tary•o+9 Prod.No.5907 Reorder:Cog Tdt-Fnte t-90D-678.9927
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DEPOSITS
PM AUDrrOR-CONTROLLER USE ONLY
DEPOSIT
PERMIT
NUMBER
IF
DATE
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0649-9665 1831000: 61108469, $100.00, Security Code Deposit, 8310-
0800, Worldwide Land Surveys, PO Box 6327, Concord, CA 94524
0649-9665 / 831000: 61115669, $3,10-0000, Flood Control Invoice 909510,
City of Brentwood, 708 Third ST, Brentwood, CA 94513
0649-9665 / 831000: 6 1115670, $2,5�, Flood Control Invoice
9109509, Laurel 198, Inc., 18001 Cowan, Suite C, Irvine, CA 92614
0649-9665 / 831000: 61115803, 15 , MS 21-93 Minor Sub Plan
Check (73), Diablo Valley Estate Co.,LLC, 101 Ygnacio Valley Rd, STE 330,
Walnut Creek, CA 94596
0649-9665 / 831000: 61115806, $1,400.00, Application Deposit FC Permit,
William G McCullough Co., General Engineering Contractors, PO' Box 2119,
Antioch, CA 94531-2119
0649-9665 / 831000: 61115544, $30,000.00, SUB 8507 Windemere Phase
II Major Sub Improvement Plan Review COA Review, Windemere RLC LLC,
3130 Crow Canyon Pl, ##310, San Ramon, CA 94583
819800-0800:1 61115550, $1,000.00, MS 11-00 Cash Bond, John M.
McKenzie, 124 Castlewood Dr., Pleasanton, CA 94566
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GULF INSURANCE COMPANY
HARTFORD, CONNECTICUT
POWER OF ATTORNEY
ORIGINALS OF THIS POWER OF ATTORNEY ARE PRINTED ON BLUE SAFETY PAPER WITH TEAL INK,
KNOW ALL MEN BY THESE PRESENTS:That the Gulf insurance Company,a corporation duly organizes under the laws of the State of Connecvcut,having
its principal office in the city of Irving,Texas, pursuant to the following resolution, adopted by the Finance & Executive Committee of the Board of Directors
of the said Company on the 10th day of August, 1993, to wit:
"RESOLVED,that the President, Executive Vice President or any Senior Vice President of the Company shall have authority to make, execute and deliver a
Power of Attorney constituting as Attorney-in-Fact,such persons,firms,or corporations as may be selected from time to time;and any such Attorney-in-s=not
may be removed and the authority granted him revoked by the President, or any Executive Vice President, or any Senior Vice President, or by to Boa,,:; of
Directors or by the Finance and Executive Committee of the Board of Directors.
RESOLVED:that nothing in this Power of Attorney shall be construed as a grant of authority to the attorneys)-in-fact to sign,execute,acknowiedge,Ceh£r
or otherwise issue a policy or policies of insurance on behalf of Gulf Insurance Company.
RESOLVED,that the signature of the President, Executive Vice President or any Senior Vice President,and the Seal of the Company may be affixed tc arra
such Power of Attorney or any certificate relating thereto by facsimile, and any such powers so executed and certified by facsimile signature and facsir,�Os
seal shall be valid and binding upon the Company in the future with respect to any bond and documents relating to such bonds to which they are attzchsec "
Gulf Insurance Company does hereby make, constitute and appoint
Frank R. Olsson Gordon J. Fischer Jocelyn Y. Quirt
its true and lawful attorneys)-in-fact, with full power and authority hereby conferred in its name,place and stead,to sign,execute,acknowledge and deliver
in its behalf, as surety, any and all bonds and undertakings of suretyship,and to bind Gulf Insurance Company thereby as fully and to the same extent as if
any bonds,undertakings and documents relating to such bonds and/or undertakings were signed by the duly authorized officer of the Gulf Insurance Comnanv
and all the acts of said attorneys)-in-fact,pursuant to the authority herein given,are hereby ratified and confirmed.
The obligation of the Company shall not exceed five million (5,000,000) dollars.
IN WITNESS WHEREOF,the Gulf Insurance Company has caused these presents to be signed by any officer of the Company and its Corporate Seal to
be hereto affixed.
�N NCECars GULF INSURANCE COMPANY
01{grt�
�.
STATE OF NEW YORK
SS °'hvec�SEAL
COUNTY OF NEW YORK Lawrence P.Miniter
Executive Vice President
On this 1st day of October, AD 2001, before me came Lawrence P. Minster, known to me personally who being by me duly sworn, did depose and say:
that he resides In the County of Bergen,State of New Jersey;that he Is the Executive Vice President of the Gulf Insurance Company,the corporation described
in and which executed the above Instrument;that he knows the seat of said corporation;that the seal affixed to the sold Instruments is such corporate seal;
that it was so affixed by order of the Board of Directors of said corporation and that he signed his name,thereto by like order.
Ile
STATE OF NEW YORK } SS _` '° LtiG ANGIE MAHABIR-BEGAZO
COUNTY OF NEW YORK J - Notary Public,State of New York
OF N No.OIMA6019988
Qualified in Kings County
Commission Expires February 16,2003
1,the undersigned,Senior Vice President of the Gulf Insurance Company,a Connecticut Corporation,00 HEREBY CERTIFY that the foregoing and attached
POWER OF ATTORNEY remains in full force.
Signed and Sealed at the City of New York. ���y��RANCe Cp�i Dated the 18th day of March 2003
SEAL � -
t
INEG
George Biancardi
Senior Vice President
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
No,5907
State of CALIFORNIA
County of rnrrruA PrOTA
On 03-J R-03 before me, M. A. ATWATER, NOTARY PUBLIC
DATE
Personally appeared Gordon J. Fischer NAME,TITLE OF OFFICER-E.G.,JANE DOE.NOTARY PUBLIC f
"
MWE(s)OF WONER(s) s
C personally known to me - OR - ® 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 ac-
knowledged to me that he/she/they executed
' the same in his/her/their authorized
capacity(ies), and that by his/her/their
signature(s) on the instrument the person(s),
or the entity upon behalf of which the
person(s) acted, executed the instrument.
WITNESS my hand and official seal.
1 {
sIt3NA I VRE OF NOTARY'
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
D INDIVIDUAL
CORPORATE OFFICER
TITLE(s) TITLE OR TYPE OF DOCUMENT
U PARTNER(S) IJ LIMITED
ATTORNEY-IN-FACT El GENERAL
TRUSTEE(S) NUMBER OF PAGES
El GUARDIAWCONSFRVATOR
Ll OTHER:
DATE OF DOCUMENT
SIGNER IS REPRESENTING:
ME
NAOF PER X"M on ENTITYpM
Gulf Insurance Company
SIGNER(S)OTHER THAN NAMED ABOVE
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b1993 NATIONAL NOTARY ASSOCIATION•8236 Remmet Ave.,P.O.Box 7184-Canoga Park,CA 91309-7184
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
County of ss.
On &.4'! , before me, >r �S 7JLoT.�.t2�/
Date �7- Nems and Tit a UR er(e.g.,"Jane 15oe,Notary Pugtfc") 'r
personally appeared _ ~—J '�,, ,zr
Name(s)of Signer(s) '
t2rpersonally known to me
to be the person(#) whose name(p) islare
subscribed to the within instrument and
acknowledged to me that he/shefthejf executed
MICHELLE25DB14t)N the same in his! authorized
comm.��+Z5061+t
r4oi�t� ppm capacity(, and that by his/
, 1a* 2t CUUNTY signature(#)on the instrument the person(#), or
the entity upon behalf of which the person(!p}
acted, executed the instrument.
WITNESS my hand and official seal
Place Notary Seal Above Sfgnatur of N ary Public
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
`title or Type of Document: r. a'y'. Y .t'�. �'
�-t
Document Date: Number of rages:
Signer(s)Other Than Named Above:
Capacity(les) Claimed by Signer
Signer's Name:
] Individual
0 Corporate Officer—Title(s): Top of thumb mere
C1 Partner--C7 Limited 0 General
] Attorney in Fact
D Trustee
0 Guardian or Conservator
11 Other:
Signer Is Representing:
d 1999 Natforwi Notary Amoclstlon•9350 N Sob Avo.,P.O.Box 2402-Cfutwworth,CA 913132402•www.na§onalnou
ry.orq Prod.No.5947 Raorder.call TON-Fro*14804.876-E827
1/'14/03 FATCO$42 00-0011
Tax Collector's Office
625 Court Street Contra William J.Poliacek
Finance Building,Room 140County Treasurer-Tax Collector
P.0.Box 631
Martinez,California 94553- �� Russell V.Watts
0063 Chief Deputy Treasurer-Tax Collector
(925)646-4122
(925)646-4135 FAX County Joslyn Mitchell
Tax Operations Supervisor
Date: 1/14/2003
IF THIS TRACT IS NOT FILED PRIOR TO THE DATE TAXES ARE OPEN FOR
COLLECTION (R&T CODE 2608) THIS LETTER IS VOID.
This will certify that I have examined the map of the proposed subdivision entitled:
Tract 1 Ms# City T.R.A.
00-0011 ALAMO
86009
Parcel#. 197-070-015-7
and have determined from the official tax records that there are no unpaid County taxes heretofore
levied on the property included in the map.
The 2002.2003 tax lien has been paid in full. Our estimate of the 2003-2004 tax lien, which
became a lien on the first day of January, 2003 is $8,800.00
This tract is not subject to a 1915 Act Bond. If subject to a 1915 Act Bond, the original principal
to calculate a segregation is
The amount calculated is void 30 days from the date of this letter.
Subdivision bond must be presented to the County Tax Collector for review and approval of
adequacy of security prior to filing with the Clerk of the Board of Supervisors.
of if ca ) WILLIAM J. POLLACEK,
f � JJ(q f C 3 6 V,& Treasurer-Tax Collector
By:
`k�:ter��'�� �•� �� =�" �(, ��: I
n
Li I .)
County of Contra Costa
Deposit Permit
Office of County Auditor-Controller
To the Treasurer Martinez, California
Received From
TREASURER TAX COLLECTOR
(Organbtation) Organization Number 0015
625 COURT ST. RM 100
Martinez, Ca. 94553
(For Cash Collection procedures see County Administrator's Bulletin 1o5.)
Descri tion Fund/Ora Sub Acct Task ---.Option Ac
SUBDIVISION GUARANTEE Amount
810900 0800
$8,800.00
Total
SUBDIVISION GUARANTEE FOR : Deposit $8,800.00
00-0011 USE TO PAY TAXES FOR 2003 DePod Consists of the fohvmng gems
ALLIED FINANCIAL_ SERVICES INC COIN and CURRENCY s :
CHECKS,M.O.,Etc. ,y,'f,`,; ;<>;
1833 KOFMAN PARKWAY
ALAMEDA CA. 94502 BAND DEPOSITS
510-864-7776 STEPHAN PINTO FOR AUDITOR-CONTROLLER USE ONLY
DEPOSIT PERMIT NUMBER AND DATE ASSIGNED:
DP#
DATE � 4103
L
The amount re money described above is for Deposit into Treasurer's receipt of above amount is Receipt of above amount hereby acknowledged.
the County Treasury.
approved.
r
Signed- "ate:
Title: UBDi 'I T T.` 3 Signed: .
JUL A signed:
5-34 Rev 5/01)ME D County
Auditor
r,M Cou- Treasurer
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