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09. ABC Hofbrau ExpressCity Hatl 10300 Torre Avenue Cupertino, CA 95014 (408) 777-3212 Fax: (408)777-3366 OFFICE OF THE CITY MANAGER SITNIII~IARY AGENDA ITEM NU1~~ER suB.riN:cr Alva Issu>~ Application for Alcoholic Beverage License. BACKGROUND Name of Business: Location: Type of Business: Type of License: Reason for Application: RECOMMENDATION Hofbrau Expr<ss 10123 North ~'Volfe Road, Suite 7 Restaurant No.41, On Sale Beer and Wine Original and ~.nnual Fees AGENDA DATE D ~ e . ~ , a Oo8 There aze no use permit restrictions or zoning restrictions which would prohibit this use, and staff has no objection to the issuance of the license. Prepared by: ~- Chao, City Planner Submii;.ted by: ~~ David :Knapp, City Manager G:planning/misc/abc/abcHofbrauExpress 9 - ~ PNnted on Recycled Paper Department of Alcoholic Beverage. Control APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S) ABC 211 (!>J99) State of California TO: Department of Alcoholic Beverage Control File Number: 473602 - 100 Paseo de San Antonio Receipt Number: 1690654 Rm. 119 ~ Geographical Code: 4303 San Jose, CA 95113 Copies Mailed Date: November 10, 2008- . Issued Date: (408)277-1200 DISTRICT SERVING LOCATION: 5AN .TOSS First Owner: HOFBRAU BEER HALL SV LLC Name of Business: HOFBRAUFXPRI.R.C Location of Business: 20123 N WOLFS RD STE 7 CUPERTINO, CA 95014-2509 County: SANTA CLARA Is premise inside city limits? Yes Census Tract 5081_01 Mailing Address: (If different from premises address) Type of license(s): 41 Transferor's license/name: / Dropping Partner: Yes No _~ License Tvne Transaction Tyke Fee Type Master Dvo Date Fee 41 ON-SALE BEBR ANO ORIGINAL FEES NA Y O 1 1 / 0 7 / O 8 - $300.00 41 ON-SALE BHBR AND ANNUAL FEE NA Y O 1 1 / 0 7 / 0 8 $339.00 41 ON-SALE BEER AND FEDERAL FINGERPRINTS NA N 4 - 1 1 / 0 7 / 0 8 $96.00 41 ON-SALE BEER AND STATE FINGERPRINTS NA N 4 1 1 / O 7 / O 8 $ 156.00 Total $891.00 Have you ever been convicted of a felony? N o Have you ever violated any provisions of the Alcoholic Beverage Control Act, or regulations of the Department pertaining to the ActT No 6zplain any 'Yes" answer [o the above questions on an attachment which shat] be deemed part of this application. Applicant agrees (a) that any manager employed in an on-sale licensed premise will have all the qualifications of a licensee, and (b) that he will not violate or cause or permit to be violated any of the provisions of the Alcoholic Beverage Control Act. STATE OF CALIFORNIA County of SANTA CLARA Date: November 7, 2008 Under penalty of perjury, each person whose signature appears below, certifies and says. (I) He is an applicant, or one of the applicants, or an executive officer of -the applicant ca rporation, named in [he foregoing application. duly authorized to make this application on its behalf; (2) that he has read the foregoing and knows the contents thereof and. that tech of the above smtemen[s therein made are true; (3) that no person other than the applicant or applicants has any direct or indirect interest in [he applicant or applicant's business to be conducted under the license(s). for which this applitnttion is made; (4) that the transfer application or proposed transfer is no[ made -to satisfy the payment of a loan or to fulfill an - agreement entered into more than ninety {90) days preceding [he day on which [he transfer application is filed with the Department or [o gain or establish a preference to or for any creditor or transferor or to defraud or injure any creditor of transferor; (5) that the tmnsfer application may be withdrawn by either the applicant or the licensee with no resulting liability to the Department. - Applicant Name(s) Applicant Signature(s) HOFBRAU BFIIZHALL SV I I.C RPP 27l Rjgnatrrrr. Psa~p 9-2 State of California APPLICATION SIGNATURE SHEET ("SIGN ON" • This form is to be used as the signature page for applications not signed In the District Office. • Read InstructIons on reverse before compietfng. • AIi sfgnatures must be notarized fn accordance w/th laws of the State where signed Department of Alcoholic Beverage Control 1. VWIYtK:)IIIY 1 iYL IV ee~{ IXltl) Sole Owner ® Partnership ~ I-iusband 8c Wife ~ Partnership-Ltd ~ Corporation ~ Limited Liability Company ~ Other 2- FILE NUMBER (H any) 3- LICENSE TYPE 4. TRANSACTION TYPE ~ Original Q Person to Person Transfer 41 ~ Exchange ~ Premise to Premise Transfer ©Other 5. APPLCANTB) NAME (Last flfsL mlddlq Hofbrau Beer Hatl SV, LLC - -_.________ _-__.-_ -_- ._-. 6. APPLICANTS MA141NG ADDRESS (Slreel edNOasIP.O- bo:. dIY. alala. zb eotle) 7. PREMISES ADDRESS (Strml adda)es, cYy, zip eaa~ 10123 N. Wolfe Road, Suite #7, Cupertino, CA 95014 APPLICANT'S CERTJF/CATlON Under penalty of perjury each person whose signature appears f - payment of a loan or to fulfill an agreement entered into more than f 90 di th d hi h th t i d applicant, or one o below, certifies and says: (~) He/She is an rans nety ( ) ng e ay on w c e er n ays prece the applicants, or an executive offs ter of the applicant named in the foregvin appplication, duly authorized corporation application is filed with the Department (h) to gain or establish a preference to or for any creditor or transferoor, or c to defraud or , to make this application on its behalf; (2) that he/sfie Has read h d h h f injure any creditor or transferor, (5) that the transfer application li t th li ith b ith th b i hd t at eac o t e the foregoing and knows the contents thereof an can or e censee w no rawn y e er e app may e w t above statements therein made are true; (3) that no person other resul.ling liability fo the Deppartment. li f f th li ithd thi if 1 f il t d than the applicant or appplicants has any direct or indirect interest licant or applican ['s business [o be conducted under the in the a o yua or e cense or w raw s i understan that a y application there will be a service charge of one-fourth of [he pp license(s) for which this application is made; (4) that the transfer application or proposed transfer Is not made to (a) satisfy the klcense fee paid, up to 5100. ' SOLE OWNER 9- PRINTED NAME (LeeL flra;L middle) SIGNATURE bAT£ SIGNED X PARTNERSHIP/LIMITED PARTNERSHIP (Signatures of general partners only) >a. PARTNER'S PRINTED NAME (ISS4 fIrBI. middle) ~ 670NATURE DATE SIGNED PARTNER'S PRINTED NAME (Lest flrsl. middle) SIGNATURE tom, L~+ --~ '~~~~ q DATA STONE, - X PARTNER'S PRINTED NAME (Last, Oral, middle) SIGNATURE lYo V RA • Z~~B X C O R P O R A T! O N - - ----- -- ------ --- - - gy~pp- - [O. PRINTED NAME RasL flnL midtlle) SIC~IATURE - 6r ' 121E V t~ IX ~'Br't ~OwD TITLE Q President ~ Vice President ~ Chairman of the Board PRINTED NAME RasL /7ra4 interne) SIGNATURE DATE SIGNED X TITLE Secretary ~ Asst. Secretary ^ Chief Financial Officer ~ Asst. Treasurer LIMITED LIABILITY COMPANY 11 . The limited Fiability company is (Wernher-run p Yes 0 No (If no, complete Item #12 below) 72. NAME OF DESIGNATED MAN~AG7,ER, MANAGING MEMBF3) OR DESIGN~AiTED OFFjI~CER (Lest, TIra4/m id~/)i ~y/ ABC INITIALS/DATE (ABC !)sB Or11J/f Liao, PhillipChuanze. 'yh ~/ Sul ~L ~"1C ~ C~~!/tst//L 1 ~ MBER'S PRtNiEO NAME (Last,- ) S~I/GNATi/R ~~~ ~ DATE SIGNED MEMBER'S PRINTED NAME (Lest first ddie) SIONATLRE ~~ I~~L + DATE SIGNED see Toy~c{shc.~ ~( X ,t~''^,,[°,tv/~t_ - --------- ----- -- ABC-211- IG 2/O "SIGN ON" 9-3 State of California APPLICATION SIGNATURE SHEET (reverse) Department of Alcoholic Beverage Control APPLlGANr'J ccrc r+r+ast++v+~ Under penalty of perjury each ppeerson whose signature appears payment of a loan or to fulfill an agreement enured into more than below, certifies and says: (~) He/She is an applicant, or one of ninety (90) days preceding the day on which the transfer - the app{icants, or an exeeuuve officer of the applicant application is filed with the Department, (b) to gain or establish a corporation, named in the foregoing ap lication duly authorized preference to or for any creditor or transferor, or (c) to defraud or to make this application on its behal F, (p2) that he/she has read tnjuro any aredilor ortransferor, (5) that the transfer application - the Foregoing and knows the contents thereof and that each of the may be withdrawn by either the applicant or the licensee with no above statements therein made are true; (3) [hat no person ocher resulting tiab[lity to the Department. than the appplicant or appplicants has any direct or indirect interest I understand that if 7 fail to qualify for the license or withdraw this in the applicant or applicant's business to be conducted under the application there will he a service charge of one-fourth of the license(s) for which this application is made• (4) that the transfer license fee paid, up to S 100. - _ application or proposed transfer Is not made Ito (a) satisfy [hc n not TlnAtAL SIGNATURES ~ ~ _ 11. PRINTED NAME (Laa4 ant. mlaae) i l G ~~ ~ 1 SIGNATURE /J X _Yf~l//r1~~~~ DAT ~ NED -m l . DATE NED P INTEO NAME (Leal. 9raL mWtlle) SIGMA X PRINTED NAME (Lad. fnL adAab) IGMA E ~ S DATE SIGNED v X ___ PRINTED NAME (Last, anL mWdie) SIGNATURE - DATE 31GNED - - X PAINTED NAME (teal 6nL ip)mba) SIGNATURE DATE STONED - X '+) ),laa~w s•~ fumy ) C - PRINTED NAME (LaaL ard, aildAlel ' i - " ~j SIGNATURE i lj `DI)(TT' ~[i-.NE~ - . u . x . ®v PRINTED NAME (tes4 first midge) 31GNATVRE _ - NO V 0 7 DASE SK'~NED x QQg PRINTED NAME (Las4 an4 mlddb) SIGNATIME x Atcc1r10tiC ~>;,=,r _ ~ d4TE SIGNED r, PRINTED NAME (t.aial. alai mlddltl ~ _ S1ri1'1ATURE - S~f~l fp~., aI ~~''rt X - PRINTED NAME neat ant middle) SIGNATURE DATE 81GNE0 X INSTRUCTION S AND GENERAL INFORMATION _ Type or print clearly in black or blue ink (do not use isd). If you need more space for signatures, use Item # 14. Premises Address (Item #7) -Enter the location-of the "ch h 1" isa lied Ownership Type (Item #1) -Check the box for the type of premises for whl t e icense pp Parrnershcps (Item #9) - The application must be signed by ownership for the business. File N++mber (item #2) - If this is an application fora each oC the partners (e.g.. general partnerships. husband and Limlred Parfn ersh cps - The application trust be etc ) wife transfer or exchange, enter the number assigned to the specific . . , signed by each of the general partners. Limited partners do noE license being transferred or exchanged. - License Type (Item #3} -Enter the numeric designation for need to sign- - Corporwrforts (item #10) -The application must be signed by the license (e.g., Type 21) or description (e. g., Off-Salt two ofTicars of the corporation, one from each Gf the following General). Trarrsacrl on Type (Item il4) -Check the box for the type of categories: (a) The chairperson of~the board, the president, or a vice president; and (b) the secretary, assistant secretary, chief transaction. ~ Applicnr+f (a) Name (item #5) -Enter the name of the financial officer, or assistant treasurer: Ll m!!ed Llabtll ry Compar+les (Item #13)- For a limited applicant. For a general partnership, the names of the individual partners. For a limited partnership, limited liability liability company that is managed by its members, the application must be signed by oath member or by sn officer company, or a corporation, the name of the entity. authorized by the articles of organization or the operating A pp!lcan!'s Malting Address (Item #6) -Enter the address where you wish to receive mail. May be different from ~ agreement to bind the company. For a limited liability company that is managed by a manager or managers, the application must [hc premises address- Business and mailing addresses ere by signed by the manager or managers or by an officer authorized public information and are available to the public. Please by [he articles of organization or the operating agreem en[ w consider this, especially when listing a mailing address. b' d [he tom an in p y. ABC-2'I 9-SIG (2/03) °S/GN ON° - - - g-4 CALLF®RN~A ALL-PURPOSE ACKNOVi/LEDGMENT State of California County of J ~~' ~ ~-~'~-~~ On ~ ° /ate D~ before me, t5 ~~"\ ~1 try-~~~ P" 40~c ~ ~ Dale - ~ Name a d Ile of Ogicar (e.g., Jane Doe, NOI~i ry PLbYc") ' personally appeared ~ ~ ~~ ~~2 v C~per;:onaliy known to me p {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. acknowledged to me that cplkstwet7f he/she~Yhey executed the same in his/her/their authorized _ NO~iAitYipt>Bl.1D-4ALiFOFifAA capacity(ies), and that by his/her their signature(s) on the ~~~~~ instrument the erson s or the anti oonnl, ,ten. tope p ( ), ty upon behalf of which the person(s) acted, executed the instrument- - WITNESS my hand-and official seal. Place Notary See( Above _ - Signature of Noary Public OPTIONAL Though the information below Is not required by law, It may pn~ve valuable to parsons relying on the document and could prevent fraudulent removes! and reattachment of this form ro another document. Description of Attached Document Trtle or Type of Document: ~ p~/1 L~'hoN St y1a~f~ri-c 5 ~PQ-~- Document Date: t o l c~`~ /o V 'T~ Ni(mber of Pages: Signer(s). Ottler Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Signer's Name: O Individual O Individual _ O Corporate Officer -Title(s): p Corporate Officer -Title(s): (7 Partner - O Limited .O Gerierat _ _ _ C] Partner - O Limited D General _ O Attomey in Fact rop of trlumb Here Q Attorney in Fac! Top of u,tmb Hare O Trustee Q Trustee O Guardian or Conservator O Guardian or Conservator O Other: D Other: Signer Is Representing: Signer Is Representing: ~~ ~"~' P ~_ '~""~ ~-,~ 3 r~ ! ~ ~ 1 `w==:aEt 1. :.! ~i,;x<:? ff lvsze~S.:==S ;~:.~ia~-`,Z-~ss'°'s1'~' S;G+'^~'11,~~T.•aziea"~~32+h :a-=5::3'3s~~3L'i:~i1'~"~tV?S.::a'~':~ - - L.'~.=Zr' ~»-~Z+Sa~"yrub: ~ci-¢-:v:°J~.Z~;:3~ss~'.^•.v. ® 2006 National Notary Assariafbn -0350 De Salo Ave., P.O. Bax 2402 - Chaleworlh, CA B73t 3-2402 Item No. 5007 Reorder T -Fee t- X827 9-5 ~aICO~'liJi3~- ~,z?4%.- ^Ca ~:~:.r:i€_. s' iSi:.r~ ,.~~fi-: i:, State of California - - Department of Alcoholic 13BVerage Control APPLICATION SIGNATURE SHEET ("SIGN OA!") - This form is to be I,tsed as the signature page for t. ows~RSNw TYPE (ctwdc orra - _ _ applications not signed in the District Office. ~ Sole QWllet' ^ COrpOiatlOn - Read instrucfions on reverse before completing. Partnership ^p Limited Liability Company - A/!signatures must be notarized /n accordance with ~ Husband 8c Wife ^ Other laws of the State whew signed [] Partnership-Ltd 2. FlLE NUMBER (N ant) S. LICENSE TYPE .1. TRANSACTION TYPE ~ Original ^ Person to Person Transfer 41 D Exchange ~ Premise to Premise Transfer ^ Other 6. APPLICANT(S) NAME (Lest, Bret, middle) HoJbrnu Beer Hall SV, LLC 6. APPLICANT'S MAILING ADDRES3 (Street eddreea/P.O. box, db. elate, Zip code) 10123 N. Wolfe Rosd Suite #7, Cupertino, CA., 95014 . T. PREMISES ADDRESS (Sfreel addraca. oaY• sIP code) 10123 N. Wolfe Road Suite #7, Cupertino, CA., 95014 APPLICANT'S CERTIFICAT/ON Under penalty ofpery'tuy each ppeerson whose signature appears below, certifies and says. (1) HelShe is an applicant, or one of li t #i ffi f h payment of a loan or to fulfill an agreement entered into more than nmcty (90) days preceding the day on which the transfer ain or establish a ith the De artment (b) to ti i fil d li e app can ve o cer o t the applicants, or an execu corporauoq named in the foregoing applicatooq duly authorized lication on its behalf; (2) that he/she has read make this a t g app ca on e w p s preference to or for any creditor or transferor, or c to defraud or iq)ure any creditor or transferor; (5) that the transfer application pp o the foregoing and knows the contents thereof and that each of the above statements therein made are true; (3) that no parson other may be withdrawn by either the applicant or the licensee with no resulting liability to the Deppartment. than the appplicant or appplicants has any direct or indirect interest to be conducted under the t li t b i i I understand that if I fail io qualiffyy for the license or withdraw this lication there will be a service cfiarge of one-Fourth of the a ness or app can a us n the plican license s) for which this application is made- (4) that the transfer applica ion or proposed transfer Is not made to (s) satisfy the pp license fee paid, up to 5100. SOLE OWNER B. PRINTED NAME (last ttraLriidde) SIGNATURE DATE SIGNED X I PARTNERSHIPlLIMITED PARTNERSHIP (Signatures of general partners only) TITLE o~J~ ^ President ^ Vice President ~ Chairman of the Board ' PRINTED NAME (Last titsl, mWdla) SIGNAT(AiE DATE SIGNED X _ TITLE ^ Se6retary ^ Asst. Secretary ^ Chief Financial Officer ^ Asst. Treasurer LIMITED LIABILITY COMPANY :7 y. The limited liability company is member-run ^ Yes Q No (If no, a~rriple6e Item #'[2 below) - t2. NAME OF DESIGNATED MANAGER M++,A^,NAGIHO MEMBER OR DESIGNATED`O,,FFlYCER (Last rus^t,'m,,Wdie) - ABC INITIALS/DATE (ABC vac aaI» Gastager, Stefan T~ h ST'~~ . Su>n ~ ~Y, ~ 1~j p C.{n G{ iS_ MEMBER'S PRINTED NAME (Cart, iMat, midde) aIGNATURE HATE SI~ Gastager, Stefan X- - _ o~ MEMBER'S PRIMED NAME (teat Brat mWdle) SIGNATURE DATE SIGN X ABG-2'I'1-SIG (2/03) - "SIGN QN° - _ Notary Pubec - 8la~ of N - County of Ci~rk g _ g RICK L ~+IMAN MY A ~y.zoit CORPORATION _ t0. PRIMED NAME (Last argil mWdle) ~ SIGNATURE ~)f~- i.3~l~e/~a DATE SIGNED X ~~n ~ 9z ~ ntlof State of Califomla Department of Alcoholic Beverage Control APPLICATION SIGNATURE SHEET ("S/GN (7N") - Tt]ls ftxm is t0 be used as the signature page for +. owNERSrIIP tCi]ar* orra) applications not signed in the District Office. Bole Q~'I7neC ~] CgrpgratiOn - Read instruct/ors on reverse before comp/et/ngr. ~ Partnership ~ L.imited Liability Company - A!I s/gnatures must be norar/zed in accordance w/th C~ Husband 8t: Wife [] C)ther /awe of rite State where signed. Q Partnership-Ltd 2 FlLE NUMBER llr any) 3. LICENSE TYPE 4. TRfrNSACTION TYPE C]/ Original D Person to Person Transfer 41 O F'-xchange [~ Premise to Premise Transfer Q Other Hofbrau Beer Hall SV, LLC 9. APPLICANT'S MAbJNG ADDRESS (Slraet adUreas/P.O. box, eHy. stele. rJp mda) 10123 N. Wolfe Road Suite #7, Gbpertino, CA., 95014 T. PREMrSE6 ADDRESS (steel addrawq rRl/, by cvtla) 10123 N. Wolfe Road Suits #7, Cupertino, CA., 95014 APPL/CANT'S CERTIF/CAT/ON Under penalty of perjury each ppaerrser whose signature appears below, certifies and says: O) He/She is an applicant, or one of l - t payment of a loan or to fulfill an agreement entered into more than -ninety (90) days precedingg the day on which the transfer i i Sl d t b t bli h li i i ith D icant the applicants, or an execu ives officer of the app corporation, named in the foregoing ap lication, duly authorized p h } o ga n or es e epartmen ( a s a app cat on s w itte preference to or for any creditor or transt'eroq or c to defraud or th t f li ti i f 5 h 2) that to make this application on its behaFf; ~ elshe has reed e rans er app ca on u;jure any cred tor or trana aror; ( ) t at the foregoing and knows the contents thereof and that tech of the play be withdrawn by ehher the applicant or the licensee with no above statements therein made are true; (3J that no parson other than the applicant or applicants has say drrect or indirect interest - d li li t' b i t be d t d th th -rlssulting Iiability to the Department. I u erstand that if I fail to ~oal)fy For the license or withdraw this es of one-fourth of the ti will be: ervice char li the ~ con er cant or app can us ness o uc e un e in s e app license(s) for which this application is made; (4) that the transfer g aa re a s a ~.pp on license fee paid, up to S 100. SOLE OWNER a PRINTED NAME elect. brat, rrartue) S16NATURE DATE SIGNED X PARTNERSHIP/LIMITED PARTNERSHIP (Signatures of general partners only) ~c O President ~ Vice President ~ Chairman ofthe Board AiC(7~')CIfIC; ~'r€-rlr ;l-.c~ o-? :':,-, Fr PRINTED NAME (Leal brat, midla) 96NATVRE .L: _a r^r Q./1TE~Z~,H3NED T)TLE ^ Secretary ^ Asst. Secretary ^ Chief Financial Officer Q Asst. Treasurer LIMITED LIABILITY COMPANY 11. The limited liabil\~it)y7/~cPompany is m/e/-mb~aCT-ru/n~ /i }~ ~[~'JyY1y^'es ~~j~No(/~ ly,(,llf( ~n/o~, com~pplea~te] Item #12 t]elow) Sun, TOngshe g V 1 `~f ~ •~ NL .l VN~UI vt~f~~ ~~ T t1 , I ~ ~ ~ Kl s) V• "'• Vt~~L/ LI!/1D ABC INITWLS/DATE (ABC ase oMyJ Sun, Tongsheng - _ ti-SIG {2/03) X "SlON ON" 9-7 CORPORATION - - +0. PRINTED NAME IL.oL Aral. mldde] SIGNATURE A 1l1 l i Q1A7E SLOpIW CALiFDRN/A ALL-PURPOSE ACKNOWLEDGMENT State of Calitornia County of ~~4vt~{ C(-~'°~ On ~ t I i-t l o~L before me, ~'" i~Y t is°~ry`e R-a ts`-` L , Date - - - .Name ana Title W Ollicar (a.g., Jane Doe, Notary Publc') personatiy appeared `Ta'~~ffSEfi~1C~l ~'--^~ Name(s) of S,B~r(s) ' personally known to me L7 (or proved to me.on the basis of satisfactory evidence) to be the person~j'"whose namg(s subscribed to the within instrument and acknowledged to me that ~~ executed the same in h~ authorized capacaty~ies), and that by hJ'x/ tr signature~on the co~ar.stlstetrs instrument the person(s), or the entity upon behalf of NosnRtrpttet.lc-c~1llPOtaNIA which the person-acted, executed the instrument. atwlwaEOt~out+rr ~.~ t...w,.>rs aooa WITNESS my hand and official seat. Place Notary Salt Auove 3igna of Notary Public OPTJONAL Though tlta Information be/ow is not requtrad by taw, n may prove valuable to parsons retyfng on the document and could prevent traudu/ent removal and reaftachment of this form to another document. 'Descriptton of Attached Document Title or Type of Document: `1F"t`~P~--tclcilbsJ S'`i ~tN tf-'~-•tl-c- ~stli~ " Document Date: tt\~~1~ ~- Signer(s).Other Than Named Above: Capacity(ies) Claimed by Signer(s) !Number of Pages Signer's Name: Signer's Name: ~ O Individual Q Individual _ O Corporate Officer -Title(s): ~ Corporate Officer -- Title(s): ~ Partner - ~ Limited .~ General _ ~ Partner - fl Limited fl General z. _ O Attorney in Fact Top or thumb Here ~ Attorney in Fact Tap of Thumb here O Trustee O Trustee O Guardian or Conservator Q Guardian or Conservator O Other. / / O Other: Signer Is Representing: </ Signer Is Representing: ~~a.-:--- .~~.x~:perss3v ~reaa~z,was-~.~avc.~~:,~~: -~zs~~a~.~:~-t~~a%~.ct?-+s~•~.tss.szt>r.-r:~..~s:~e.;,:a•.:~: ® 2006 National Notary Assodatbn - 8360 De Solo Ava., P.O. Box 2402 • Chatswor[b, C.^. 91313-2402 Ilarn No. 5907 Fiaarder: Call Tdl•Free 1-80D-878-6827 9-8