00-128 Improvement Agreement, Gwozdz & GarlieppRECORDING REQUESTED BY
City of Cupertino
WHEN RECORDED MAIL TO
City Clerk's Office
City of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
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DOCUMENT: 16492708 Titles~1 /Pages 3
Fees....* No Fees
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AMT PAID
E3RENDA DAV[S RDE # 006
SANTA CLARA COUNTY RECORDER 9/23/2002
Recorded at the request of 838 AM
City
;SPACE ABOVE THIS LINE FOR RECORDER'S USE)
NO FEE INACCORDANCE
WITH GOV. CODE 6103
CERTIFICATE Ole COMPLETION
AND
NOTICE OF ACCEPTArfCE OF COMPLETION
PETER S. AND BARBARA K. GWOZDZ
10363 BYRN]E AVENUE
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Original
~ For Fast Endorsement
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CITY OF
CUPEI~TIN(J
City Hall
10300 Torre Avenue
Cupertino, CA 95014-3255
(408) 777-3354
PUBLIC WORKS DEPARTMENT
CERTIFICATE OF COMPLETION
ANI)
NOTICE OF ACCEPTANCE OF COMPLETION
NOTICE IS HEREBY GIVEN THAT I, Ralph A. Qualls, Jr., Director of Public Works and
City Engineer of the City of Cupertino, California, do hereby certify that the municipal improvements
in conjunction with the following project:
PETER S. AND BARBARA K. GWOZDZ,10363 BYRNE AVENUE
have been completed in accordance with the approved improvement plans and acceptance of
completion was ordered by the City Council on September 3, 2002.
~~ ~
`~~-
l~irector of Public Works and
~~ity Engineer of the City of Cupertino
Date: September 4, 2002
Printed on Recycled Paper
VERIFICATION
I have reviewed this Certificate of Completion and Notice of Acceptance of
Completion. To the best of my knowledge, the information contained herein is true and
complete.
I verify under penalty of perjury under thE~ laws of the State of California, that the
foregoing is true and correct.
Executed on the 6`" day of September 2002 at Cupertino, California.
Administrative Clerk
City of Cupertino
RESOLUTION NO.00-272
A RESOLUTION OF THE CITY COUr1CIL OF THE CITY OF CUPERTINO
AUTHORIZING EXECUTION OF IMPROVEMENT AGREEMENT
BETWEEN THE CITY AND DEVE-LOPERS PETER GWOZDZ AND
BARBARA GWOZDZ AND JON M. G~,RLIEPP AND CAROL K. GARLIEPP,
10363 BYRNE AVENUE APN 357-12-029
WHEREAS, there has been presented to the City Council a proposed improvement
agreement between the City of Cupertino and dc;velopers, Peter Gwozdz and Barbara Gwozdz,
and Jon M. Garliepp and Carol K. Garliepp for the installation of certain municipal
improvements at 10363 Byrne Avenue and said agreement having been approved by the City
Attorney, and Developers having paid the fees as outlined in the attached Exhibit A;
NOW, THEREFORE, BE IT RESOLVI?D THAT the Mayor and the City Clerk are
hereby authorized to sign the aforementioned agreement on behalf of the City of Cupertino.
PASSED AND ADOPTED at a regular meeting of the City Council of the City of
Cupertino this 6"' day of November, 2000, by the following vote:
Vote Members of the City Council
AYES: Burnett, Chang, James, Lowenthal, Statton
NOES: None
ABSENT: None
ABSTAIN: None
ATTEST: APPROVED:
/s/Kimberly Smith /s/John Statton
City Clerk Mayor, City of Cupertino
Resolution No. 00-272
EXHIB)_T "A"
SCHEDULE OF BOND, =FEES, AND DEPOSITS
DEVELOPMENT: 10363 Byrne Avenue
Peter Gwozdz and Barbara Gwozdz, and
Jon M. Garliepp and Carol K. Garliepp
LOCATION: 10363 Byrne Avenue
A. Faithful Performance Bond: $ 3,500.00
THR EE THOUSAND FIVE HUNDRED AND 00/100 DOLLARS
B. Labor and Material Bond: $ 3,500.00
THREE THOUSAND FIVE HUNDRED AND 00/100 DOLLARS
C. Checking and Inspection Fees: $ 1,975.00
ONE THOUSAND NINE HUNDRED SEVENT'~ FIVE AND 00/100 DOLLARS
D. Indirect City Expenses: N/A
E. Development Maintenance Deposit: $ 1,000.00
ONE THOUSAND AND 00/100 DOLLARS
F. Storm Drainage Fee: $ 284.00
TWO HUNDRED EIGHTY-FOUR AND 00/100 DOLLARS
G. One Year Power Cost: N/A
H. Street Trees: By Developer
I. Map Checking Fee: N/A
J. Park Fee: Zone I N/A
K. Water Main Reimbursement: N/A
L. Maps and/or Improvement Plans: As specified in
Item #23 of agreement
Page 2
AGREEMENT
10363 Byri-e Avenue
APN 357'-12-029
This AGREEMENT made and entered into this _ day of 2000, by and between
the CITY OF CUPERTINO, a municipal corporation of the State of California, hereinafter
designated as CITY, and Peter Gwozdz and Barbara Gwozdz and Jon M. Garliepp and
Carol K. Garliepp hereinafter designated as DEVELOPER.
WITNESSETH
WHEREAS, THE DEVELOPER has made application to the CITY to SECURE A
BUILDING PERMIT TO construct a Single Family Home hereinafter referred to as "Project".
WHEREAS, CITY hereby approves the improvement plans and specifications prepared for
the Project by Engineer a true copy of which imI>rovement plans and specifications are on file in
the office of the City Engineer of Cupertino; and
full;
WHEREAS, the same are incorporated herein by reference, the same as though set out in
NOW, THEREFORE, said improvement plans and specifications shall be hereinafter
called the "Plans", and the work to be done under the Plans shall be called the "Work".
Page 1 of 11
File No.: 52,270
WHEREAS, pursuant to the provisions of this AGREEMENT, the CITY hereby established the
amounts of Bonds, Fees, and Deposits as set forth in the following schedule:
SCHEDULE OF BONDS.. FEES AND DEPOSITS
Street Improvement Category:
PART A. Faithful Performance Bond: $3,500
110-2211
PART B. Labor and Material Bond: $3,500
110-2211
PART C. Checking and Inspection Fee: $1,975
110-4538
PART D. Indirect City Expenses: N/A
PART E. Development Maintenance Deposit: $1,000
110-2211
PART F. Storm Drainage Fee: Basin 2 $284.00
Account #: 215-4072
PART G. One Year Power Cost: N/A
110-4537
PART H. Street Trees: By Developer N/A
PART I. Map Checking Fee: N/A
110-4539
PART J. Park Fee: ZONE I N/A
ACCT #: 280-4081
PART K. Water Main Reimbursement Fee: N/A
110-4554
PART L. Maps and/or Improvement Plans
As Specified in Item #23
Page 2 of 11
NOW, THEREFORE, IT IS HEREBY MUTUALLY AGREED by and between the parties
hereto as follows, TO WIT:
1. DEDICATION
A. The DEVELOPER offers to dedicate the real property shown on Exhibit "A",
which is attached hereto and made a part hereof by reference. Said dedicated property
shall be free and clear of all liens or encumbrances except those which the CITY shall
waive in writing. The DEVELOPER agrees not to revoke said offer of dedication, and to
keep said offer open until the CITY accepts offer by resolution.
B. Upon execution of this AGREEMENT the DEVELOPER agrees to deliver a
properly executed grant deed to the CITY of the real property described in Exhibit "A",
and such other executed conveyances, or instruments necessary to convey clear title as
herein required. The DEVELOPER shall provide, at the DEVELOPER'S sole cost and
expense, to the City:
(1) A preliminary title report issued by a title insurance company relating to the
property offered for dedication.
(2 A standard policy of title insurance issued by a title insurance company and
insuring the CITY in the sum of: N/A, and which shall show said property
free and clear of all liens or encumbrances except those as the CITY shall
expressly waive in writing; ~~aid policy shall be furnished at the time of
acceptance of dedication and recordation of deed.
C. Upon the condition precedent that the DEVELOPER shall perform each and every
covenant and condition of this AGREEMENT, the CITY agrees to accept said real
property offered for dedication.
2. INSTALLATION OF WORK
It is further agreed that:
A. The DEVELOPER shall install and complete the Work within one (1) year from the
date of execution of this AGREEMENT, or such longer period as may be specifically
authorized in writing by the City Engineer. In the event the DEVELOPER fails or refuses
to complete the Work within the specified period of time, the CITY, at its sole option, shall
be authorized to complete the Work, in wh~.tever manner the CITY shall decide. In the
event the CITY completes the Work, the CITY may recover any and all costs incurred
thereby from the DEVELOPER or the DEVELOPER'S surety or both. No final inspection
shall be granted or street improvements shall not be accepted unless all the requirements
for safety purposes are installed such as sidewalks, handicap ramps, street lights, etc.
Page 3 of 11
B. The DEVELOPER shall install and complete the Worlc in a good and workmanlike
manner in accordance with the plans as approved by the City Engineer of Cupertino. The
Work shall be done in accordance with existing ordinances and resolutions of the CITY
and in accordance with all plans, specifications, standards, sizes, lines, and grades
approved by the City Engineer. The Work shall be done in accordance with all State and
County Statutes applicable hereto. The decision of the City Engineer shall be final as to
whether any material or workmanship meets the standards, specifications, plans, sizes lines
and grades as set forth.
C. It is further agreed that the Work shall be done in accordance with the most current
Standard Specifications of the Department ~~f Public Works, California Department of
Transportation, State of California, and in accordance with the specifications of the
Cupertino Sanitary District where applicable.
Wherever the words "State" or "California Division of Highways" are mentioned in the
State Specifications, it shall be considered as referring to the CITY of Cupertino; also
wherever the "Director" or "Director of PuY~lic Works" is mentioned, it shall be considered
as referring to the City Engineer.
In case of conflict between the State Specifications and the specifications of the CITY,
and/or the Cupertino Sanitary District, the specifications of the CITY and/or the Cupertino
Sanitary District shall take precedence over and be used in lieu of such conflicting
portions.
3. EXCAVATION PERMIT
It is further agreed that the DEVELOPER :;hall comply with Section Three of Ordinance
No. 130 of the CITY by obtaining an excavation permit from the City Engineer before the
commencement of any excavation in, on, or under the surface of any existing public street,
lane, alley, sidewalk, or other public place. It is further agreed that the DEVELOPER shall
notify the City Engineer of the exact date acid time when the proposed excavation is to
commence.
4. QUITCLAIM DEED
It is further agreed that the DEVELOPER, ~Nhen requested by the CITY, shall quitclaim all
his rights and interests in, and shall grant to CITY authorization to extract water from the
underground strata lying beneath said proje;.t and DEVELOPER agrees to execute a
"Quitclaim Deed and Authorization" in favor of CITY, when presented to him for
signature.
5. BONDS AND OTHER SECURITY
Page 4 of 11
A. Upon the execution of this AGREEMENT, the DEVELOPER shall file with the
CITY a faithful performance bond to assurf; his full and faithful performance of this
AGREEMENT. The penal sum of said faithful performance bond shall be the full cost of
any payment to be made under this AGREI=;MENT, the value of any land agreed to be
dedicated, and any improvements are to be made under this AGREEMENT. In the event
that improvements are to be made under this AGREEMENT, the DEVELOPER shall, in
addition to said faithful performance, file with the CITY a labor and materials bond in a
penal sum adequate to assure full payment ~~f all labor and materials required to construct
said improvements. The amount of said bonds shall be as designated by the City Engineer.
Said bonds shall be executed by a surety company authorized to transact a surety business
in the State of California and must be approved by the City Attorney as to form and by the
City Engineer as to sufficiency. In the event that the DEVELOPER shall fail faithfully to
perform the covenants and conditions of this AGREEMENT, or to make any payment, or
any dedication of land, or any improvements herein required, the CITY shall call on the
surety to perform this AGREEMENT or otherwise indemnify the CITY for the
DEVELOPER'S failure to so do.
B. In lieu of a surety bond, the DEVELOPER may elect to secure this AGREEMENT
by depositing with the CITY:
1. Cash; or,
2. A cashier's check, or a certified check payable to the order of the City of
Cupertino; or,
3. A certificate of deposit, or ir.~strument of credit meeting the requirements of
Government Code Section 66499 (b) or (c).
C. The amount of said cash, checks, certificate of deposit, or instrument of credit shall
be as designated by the City Engineer, and shall be the equivalent to that which would have
been required had the DEVELOPER furnished the CITY with a surety bond. 7n the event
that the DEVELOPER shall fail faithfully to perform the covenants and conditions of this
AGREEMENT, or to make any payment, o:r any dedication of land, or any improvements
herein required, the CITY may apply the proceeds of said security thereto.
D. No release of surety bond, cash deposit, check, or certificate of deposit, shall be
made except upon approval of the City Council.
Schedule for bond and insur~~nce release for paper bonds are as follows:
A. Release of S'0 percent of the faithful performance bond
upon acceptance by City Council
B. Release of t:he remaining 10 percent of the performance
bond at one year from a~~ceptance after all deficiencies have been
corrected and in the absence of any claim against such bond.
Page 5 of 1 I
C. Release of the entire labor and material bond at six months
from acceptance after all deficiencies have been corrected and in the
absence of any claim against such bond.
D. Liability insurance, provided by the developer to hold the City
harmless in the event of liability arising from the project, to be retired
at the end of one year if all deficiencies have been corrected and in the
absence of any claim against such insurance.
2. Schedule for Bond and Insurance Release for Cash, CD, Set-Aside Letter
are as Follows:
A. Release of q-5% of bond upon acceptance by City Council.
B. Release of a.dditiona145% at six months from acceptance
after all deficiencies have been corrected and in the absence of any
claim against such bond.
C. Release of remaining 10% at one year from date of
acceptance after all deficiencies have been corrected and in the absence
of any claim against such bond.
D. Release of the liabi:~ity insurance, provided by the developer or
contractor to hold the C ty harmless in the event of liability arising
from the subject project., at the end of one year if all deficiencies have
been corrected and in the absence of any claims against such insurance.
E. No interest shall be paid on any security deposited with the CITY.
6. CHECKING AND INSPECTION FEE
It is further agreed that DEVELOPER shall pay any and all necessary direct expenses for
inspection, checking, etc., incurred by CIT~~ in connection with said Project, and that
DEVELOPER shall have deposited with CITY, prior to execution of this AGREEMENT,
the amount as set forth herein at Page 2 (Part C.). Should construction cost vary materially
from the estimate from which said sum is arlculated, the City Engineer shall notify
DEVELOPER of any additional sum due acid owing as a result thereof.
7. INDIRECT EXPENSES
It is further agreed that DEVELOPER shall pay to CITY, prior to execution of this
AGREEMENT, indirect expense allocable •_o processing these improvements, the amount
as set forth herein at Page 2 (Part D).
Page 6 of 11
8. MAP CHECKING FEE
It is further agreed that the DEVELOPER ;hall deposit with CITY, prior to execution of
this AGREEMENT, for office checking of final map and field checking of street
monuments, in compliance with Section 4::, of Ordinance No. 47 (Revised 12/04/61) of
CITY, the amount as set forth herein at Page 2 (Part I).
9. DEVELOPMENT MAINTENANCE DEPOSIT
It is further agreed that the DEVELOPER shall pay to the CITY, prior to execution of this
AGREEMENT, the amount set forth herein at Page 2 (Part E) as a development
maintenance deposit to insure proper dust control and cleaning during the construction
period. The development maintenance dep~~sit may be utilized for repairs of defects and
imperfections arising out of or due to faulty workmanship and/or materials appearing in
said work during the period until release of the surety bonds or other security permitted
under paragraph S.B by the CITY.
Should the DEVELOPER complete the req~.~ired repairs to the entire satisfaction of the
CITY, the unused balance will be returned sifter the release of the surety bond or other
security permitted under paragraph S.B.
10. STORM DRAINAGE FEE
It is further agreed that the DEVELOPER s_!lall deposit with the CITY, prior to execution
of this AGREEMENT, a storm drainage charge in connection with the said Project in
accordance with the requirements establishf~d in Resolution 4422, March 21, 1977, in the
amount as set forth herein at Page 2 (Part F;-.
11. WATER MAIN EXTENSION DEPOSIT
The DEVELOPER further agrees to deposit: with the CITY those monies required to
comply with "Policy on Water Main Extensions Work and Deposits" dated 9/30/77. The
deposit shall be held by the CITY until said monies are needed to implement
improvements outlined by the Director of Public Works or improvements outlined within
the adopted Water Master Plan.
The amount shown herein at Part K, Page 2, shall be the full amount due.
12. ONE YEAR POWER COST
Page 7 of 11
It is further agreed that the DEVELOPER shall pay to the CITY prior to execution of this
AGREEMENT, the amount as set forth herein at Page 2 (Part G), which amount represents
the power cost for street lights for one year.
13. THE INSTALLATION OF STREET TREES
It is further agreed that the DEVELOPER shall, at such time as deemed appropriate by the
City Engineer, plant street trees in conform,~nce with the standards of the City of
Cupertino. Variety of tree shall be selected from the City approved list.
14. PARK FEES
It is further agreed that the DEVELOPER shall pay such fees and/or dedicate such land to
the CITY, prior to execution, as is required within Section 18-1.602 Park Land Dedication,
Cupertino Municipal Code, and which is further stipulated under Part J, Page 2 herein.Fees
are also in accordance with action adopted ley the City Council on March 19, 1991 and
Chapter 14.05 or Section 18-1.602 of the C upertino Municipal Code.
15. MAINTENANCE OF WORK
It is further agreed that the DEVELOPER shall maintain the Work until all deficiencies in
the Work are corrected to conform to the Plans and the City Standards and Specifications
for the Work. The DEVELOPER shall, upon written notice thereof, immediately repair or
replace, without cost or obligation to the City of Cupertino, and to the entire satisfaction of
said CITY, all defects and imperfections arising out of or due to faulty workmanship
and/or materials appearing in said Work.
16. SANITARY DISTRICT
It is further agreed that the DEVELOPER :;hall file with CITY, upon execution of this
AGREEMENT, a letter from the Cupertino Sanitary District stating that the DEVELOPER
has entered into a separate AGREEMENT with the said District to install sanitary sewers
to serve all lots within said Project and stating that a bond to insure full and faithful
performance of the construction of the said sanitary sewers and to insure maintenance of
said sanitary sewer in conformance with they provisions as set forth in Paragraph 15 above
has been filed.
17. GOVERNMENT CODE
It is further agreed that DEVELOPER shall file with CITY, upon execution of this
AGREEMENT, substantial evidence that .all provisions of Section 66493, Article 8,
Chapter 4 of the Government Code, pertaining to special assessments or bonds, have been
complied with.
Page 8 of 11
18. CENTRAL FIRE DISTRICT
It is further agreed that the DEVELOPER shall file with the CITY, upon execution of this
AGREEMENT, a letter from the Central lire Protection District of Santa Clara County,
stating that the DEVELOPER has entered into an AGREEMENT with said District to
install fire hydrants to serve said Project and stating that all necessary fees have been
deposited with said District to insure installation and five (5) year rental fee of said
hydrants.
19. PACIFIC GAS AND ELECTRIC/PACIFIC BELL
It is further agreed that the DEVELOPER shall pay to Pacific Gas and Electric Company
and/or to PACIFIC BELL Company any <<nd all fees required for installation of overhead
and/or underground wiring circuits to all e~lectroliers within said property and any and all
fees required for undergrounding as provided in Ordinance No. 331 of CITY when
DEVELOPER is notified by either the City Engineer or the Pacific Gas and Electric
Company and/or Pacific Bell Company that said fees are due and payable.
20. EASEMENTS AND RIGHT-OF-WAY
It is further agreed that any easement and :right-of--way necessary for completion of the
Project shall be acquired by the DEVELOPER at his own cost and expense.
It is provided, however, that in the event eminent domain proceedings are required the
CITY for the purpose of securing said easement and right-of--way, that the DEVELOPER
shall deposit with CITY a sum covering the reasonable market value of the land proposed
to be taken and to be included in said sum shall be a reasonable allowance for severance
damages, if any. It is further provided that in addition thereto, such sums as may be
required for legal fees and costs, engineering, and other incidental costs in such
reasonable amounts as the CITY may require shall be deposited with the City of
Cupertino.
21. HOLD HARMLESS
It is further agreed that, commencing with t.~e performance of the Work by the
DEVELOPER or his contractor and continuing until the completion of the maintenance of
the Work, the DEVELOPER shall indemnify, hold harmless and defend the CITY from
and against any or all loss, cost, expense, damage or liability, or claim thereof, occasioned
by or in any way whatsoever arising out of the performance or nonperformance of the
Work or the negligence or willful misconduct of the DEVELOPER or the DEVELOPER'S
agents, employees and independent contractors, except to the extent any of the foregoing is
caused by the negligence or willful misconduct of the CITY or the CITY's agents,
employees and independent contractors.
Page 9 of 1 1
22. INSURANCE
It is further agreed that: The DEVELOPER: shall take out, or shall require any contractor
engaged to perform the work to take out, ar~d maintain at all times during the performance
and maintenance of the work called for or required to be done hereunder, a policy of
insurance naming the CITY and members of the City Council of the City of Cupertino
individually and collectively, and the officers, agents and employees of the CITY
individually and collectively, as insured. S;~id separate policy shall provide bodily injury
and property damage coverage to the foregoing named CITY and individuals covering all
the Work performed by, for, or on behalf oi~ said DEVELOPER. Both bodily injury and
property damage insurance must be on an occurrence basis; and said policy or policies
shall provide that the coverage afforded thereby shall be primary coverage to the full limit
of liability stated in the declarations, and if the city, its members of the City Council
individually and collectively, and the officers, agents, and employees of the CITY,
individually and collectively, have other insurance against the loss covered by said policy
or policies, that other insurance shall not be called upon to cover a loss under said
additional policy.
The insurance carrier shall provide proof of'their ratings. All ratings shall be a minimum
of "Best A-7" in accordance with ABAG policies.
A. Each of said policies of insurance shall provide coverage in the following minimum
amounts: For bodily injury, $100,000 each person; $300,000 each occurrence, property
damage, $50,000 on account of any one occurrence with an aggregate limit of not less than
$200,000.
B. The DEVELOPER shall file with the City Engineer at or prior to the time of
execution of this AGREEMENT by the DEVELOPER such evidence of said foregoing
policy or policies of insurance as shall be satisfactory to said City Engineer. Each such
policy or policies shall bear an endorsemem: precluding the cancellation or reduction in
coverage without giving the City Engineer at least ten (10) days advance notice thereof.
The CITY shall be shown as additionally insured on a separate "Additional Insured
Owners, Lessees or Contractors" (Form A) or (Form B) Endorsement provided along with
the evidence of said foregoing policy of policies of Insurance
C. In the event that the Project covered herein should be mutually situated in or affect
the area of jurisdiction of a separate municipality or political subdivision of the State of
California, the policies of insurance required herein and above shall co-name such
municipality or political subdivision and the provision set forth herein and above for the
protection of the CITY shall equally apply t o municipality and political subdivision.
23. MAPS AND/OR IMPROVEMENT PLANS
Page 10 of 11
It is further agreed that the CITY shall obtain the following map and/or plans at the
DEVELOPER'S expense:
A. A mylar sepia and seven (7) prints of fully executed parcel map.
B. A mylar sepia and ten (10) prints of fully executed improvement plans.
C. A scan in CAD format of all executed improvement plans and map.
The DEVELOPER agrees to pay the CITY from the development maintenance deposit the
cost for all prints of plans and map required. under Item 23.
24. SUCCESSORS
This AGREEMENT shall bind the heirs, administrators, executors, successor, assignee and
transferees of the DEVELOPER. The assigizment of this AGREEMENT shall not be
made without approval by the City Council of the City of Cupertino.
IN WITNESS WHEREOF, CITY has caused its name to be hereunto affixed by its Mayor
and City Clerk, thereunto duly authorized by resolution of the City Council and said
DEVELOPER has hereunto caused his name to b~~ affixed the day and year first above written.
Approved as to form:
City Attorney
Notary Acknowledgment Required
Exhibit A Attached
CITY OF CUPERTINO:
' ~;,, =;t ,~''
Li ~~
Mayor
Crty Cle
Page 11 of 11
Exhibit A
State of California
County of Santa Clara
On October 20, 2000_ before me, the undersigned, a Notary Public in and for said State,
personally appeared Barbara C-kvozdz and Peter C~vozdz and John M. Garliepp and Carol
Garliepp personally ]mown to me (or provE~cl to me on the basis of satisfactory
evidence) to be the person(s) whose name(s) ._s/are subscribed to the within instrument
and aclmowledged 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 instnunent.
WITNESS my hand official seal.
Signature I
Name ~ ~ ~-~~ ~ `~ ~~
(typed or printed) (Seal)
/ ~y /1 M
K~1 ~:` ~ ' =1 ~!OTrti ~_ -AL.rC kNIA `..
(:i1~~ r$t+ ~ ~ SA~i~rt,4~AlUUhiTY
~~ \. _,/ My Ccrntr ;pirr ~!ov. ?7, 200?"~
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