Loading...
21-184 Encroachment Agreement, GTE Mobilnet of California Limited Partnership, dba Verizon Wireless, R.O.W, 20306 Clifden WayThis Encroachment Agreement (“Encroachment Agreement”), made as of the last date signed below (“Effective Date”) between the City of Cupertino, a political subdivision of the State of California, hereinafter designated “Licensor” and GTE Mobilnet of California Limited Partnership, d/b/a Verizon Wireless, with its principal offices at c/o Verizon Wireless, 180 Washington Valley Road, Bedminster, New Jersey 07921, hereinafter designated “Licensee”: 1.Encroachment Agreement. This is an Encroachment Agreement as referenced in that certain Small Cell License Agreement between Licensor and Licensee dated May 16, 2017 ("Agreement"). This Encroachment Agreement shall serve as an encroachment license. All of the terms and conditions of the Agreement are incorporated hereby by reference and made a part hereof without the necessity of repeating or attaching the Agreement. In the event of a contradiction, modification or inconsistency between the terms of the Agreement and this Encroachment Agreement, the terms of the Encroachment Agreement shall govern. Capitalized terms used in this Encroachment Agreement shall have the same meaning described for them in the Agreement unless otherwise indicated herein. 2.Project Description and Locations. Licensee shall have the right to use the ROW for a Small Cell at the designated areas in the ROW as further described in Attachment 1 attached hereto (the “Licensed Area”). 3. Equipment. The Small Cell to be installed at the Licensed Area is described in Attachment 1 attached hereto. 4.Term. The term of this Encroachment Agreement shall be as set forth in Section 2 of the Agreement. 5.Fees. The initial annual Rent for the term of this Encroachment Agreement shall be Three Hundred Dollars ($300) and paid in accordance with Paragraph 5.1 of the Agreement, as amended by Section 4, to that certain Settlement Agreement and Mutual Release entered into between Licensor and Licensee dated October 4, 2017, and as adjusted by Paragraph 5.2 of the Agreement. 6.Commencement Date. The first day of the month following the date Licensee has Commenced Installation of its Equipment at the Licensed Area. 7. Approvals/Fiber. It is understood and agreed that Licensee's ability to use the Licensed Area is contingent upon its obtaining all of the certificates, permits and other approvals (collectively the "Governmental Approvals") that may be required by any Federal, State or Local authorities, as well as a satisfactory fiber and electrical connection which will permit Licensee use of the Licensed Area as set forth above. In the event that (i) any of such applications for such Governmental Approvals should be finally rejected; (ii) any Governmental Approval issued to Licensee is canceled, expires, lapses, or is otherwise withdrawn or terminated by governmental authority; (iii) Licensee determines that such Governmental Approvals may not be obtained in a SF_CUPERTINO_024 20306 Clifden Way, Cupertino, CA 95014 ENCROACHMENT AGREEMENT 417718DocuSign Envelope ID: 3D64C662-089D-4E8D-A5A5-6AE4C3B8DEECDocuSign Envelope ID: 4DFFE21A-F701-48B4-9895-C513A850B8C0 timely manner; (iv) Licensee determines that it will be unable to obtain in a satisfactory manner, or maintain any fiber or power connection; or (v) Licensee determines that the Licensed Area is no longer technically compatible for its use, Licensee shall have the right to terminate this Encroachment Agreement. Notice of Licensee's exercise of its right to terminate shall be given to Licensee in writing by certified mail, return receipt requested, and shall be effective upon the mailing of such notice by Licensee, or upon such later date as designated by Licensee. All rentals paid to said termination date shall be retained by Licensor. Upon such termination, this Encroachment Agreement shall be of no further force or effect except to the extent of the representations, warranties and indemnities made by each party to the other hereunder. Otherwise, Licensee shall have no further obligations for the payment of Rent to Licensor. 8.Miscellaneous. N/A [Signature page follows] DocuSign Envelope ID: 3D64C662-089D-4E8D-A5A5-6AE4C3B8DEECDocuSign Envelope ID: 4DFFE21A-F701-48B4-9895-C513A850B8C0 EXECUTED to be effective as of the last date shown below. LICENSOR: City of Cupertino, a political subdivision of the State of California By: ___________________________ Name: _________________________ Title: __________________________ Date: ___________________________ ATTEST: Date: ___________________________ APPROVED AS TO FORM CITY ATTORNEY’S OFFICE BY: __________________________ Print Name: _____________________ Date: __________________________ City Attorney LICENSEE: GTE MOBILNET OF CALIFORNIA LIMITED PARTNERSHIP, D/B/A VERIZON WIRELESS by Cellco Partnership, its General Partner By: Date: ______________________________ Name: Alba Barber Title: Senior Real Estate Manager Exhibits: Attachment 1 , Clerk DocuSign Envelope ID: 3D64C662-089D-4E8D-A5A5-6AE4C3B8DEECDocuSign Envelope ID: 4DFFE21A-F701-48B4-9895-C513A850B8C0 Apr 6, 2021 Apr 8, 2021 Heather Minner Apr 8, 2021 Chad Mosley City Engineer Apr 8, 2021 Attachment 1 Licensed Area See attached. DocuSign Envelope ID: 3D64C662-089D-4E8D-A5A5-6AE4C3B8DEECDocuSign Envelope ID: 4DFFE21A-F701-48B4-9895-C513A850B8C0 T-1 TITLE SHEET DRAWN BY: CHECKED BY: IT IS A VIOLATION OF THE LAW FOR ANY PERSON, UNLESS THEY ARE ACTING UNDER THE DIRECTION OF A LICENSED PROFESSIONAL ENGINEER, TO ALTER THIS DOCUMENT REV DATE DESCRIPTION MODUS, LLC 240 STOCKTON ST., 3RD FLOOR SAN FRANCISCO, CA 94108 APPROVED BY:LJB VERIZON WIRELESS 2785 MITCHELL DRIVE, SUITE 9 WALNUT CREEK, CA 94598 BPM APE 0 08/03/20 100% CD SF_CUPERTINO_024 CUPERTINO, CA 95014 (IFO) 20306 CLIFDEN WAY 1 11/19/20 100% CD PLAN CHECK 2 12/09/20 100% CD PLAN CHECK SITE INFORMATION SITE ADDRESS: OWNER: APPLICANT: LATITUDE: LONGITUDE: COUNTY: ASSESSORS PARCEL NUMBER: ZONING: ELEVATION: CITY OF CUPERTINO 10300 TORRE AVE CUPERTINO, CA 95014 VERIZON WIRELESS 2785 MITCHELL DRIVE, SUITE 9 WALNUT CREEK, CA 94598 37.313329 N NAD83 -122.028871 W NAD83 SANTA CLARA PUBLIC RIGHT OF WAY NEAR 36936026 CITY OF CUPERTINO 231.57' AMSL VICINITY MAPPOLE PHOTO N DRAWING INDEX T-1 SHEET NO. TITLE SHEET T-2 GENERAL NOTES A-1 SITE PLAN & ENLARGED SITE PLAN A-3 A-4 ELEVATIONS CIRCUIT DIAGRAM D-1 DETAILS CODE COMPLIANCE ALL WORK AND MATERIALS SHALL BE PERFORMED AND INSTALLED IN ACCORDANCE WITH THE CURRENT EDITIONS OF THE FOLLOWING CODES AS ADOPTED BY THE LOCAL GOVERNING AUTHORITIES. NOTHING IN THESE PLANS IS TO BE CONSTRUCTED TO PERMIT WORK NOT CONFORMING TO THESE CODES. ·2019 CALIFORNIA CODE ·2019 CALIFORNIA BUILDING CODE (CBC), BASED ON THE 2018 IBC ·2019 CALIFORNIA RESIDENTIAL CODE (CRC), BASED ON THE 2018 IRC ·2019 CALIFORNIA ELECTRICAL CODE (CEC), BASED ON THE 2017 NEC ·2019 CALIFORNIA MECHANICAL CODE (CMC), BASED ON THE 2018 UMC ·2019 CALIFORNIA PLUMBING CODE (CPC), BASED ON THE 2018 UPC ·2019 CALIFORNIA GREEN BUILDINGS STANDARDS CODE (CALGREEN) ·2019 CALIFORNIA FIRE CODES WITH ALL LOCAL AMENDMENTS ·ANY LOCAL BUILDING CODE AMENDMENTS TO THE ABOVE ·CITY / COUNTY ORDINANCES SHEET TITLE E-1 ELECTRICAL GENERAL NOTES E-2 ONE-LINE DIAGRAM & GROUNDING SCHEMATIC E-3 ELECTRICAL DETAILS ACCESSIBILITY REQUIREMENTS FOR PERSONS WITH DISABILITIES: FACILITY IS UNMANNED AND NOT FOR HUMAN HABITATION. ACCESSIBILITY IS NOT REQUIRED IN ACCORDANCE WITH CALIFORNIA ADMINISTRATIVE STATE CODE PART 2, TITLE 24, CHAPTER 11B, SECTION 1103B. SURVEY PROJECT TEAM PROJECT DESCRIPTION D-2 DETAILS VERIZON WIRELESS PROPOSES TO INSTALL A NEW WIRELESS COMMUNICATION SITE ON A LIGHT POLE IN THE PUBLIC RIGHT-OF-WAY. SCOPE: ·INSTALL (1) NEW CANISTER ANTENNA INSIDE NEW FRP CONCEALMENT SHROUD ON TOP OF POLE ·INSTALL (2) 5G ANTENNA/RADIOS ·INSTALL (2) RRUS-32 RADIOS ·INSTALL (2) PSU-AC08 BEHIND RADIOS ·INSTALL NEW COAX FROM EQUIPMENT TO NEW ANTENNA WITHIN POLE ·INSTALL (1) NEW SMART METER / DISCONNECT ON SIDE OF POLE ·INSTALL NEW POLE AND FOUNDATION TO REPLACE EXISTING THE UTILITIES SHOWN HEREIN ARE FOR THE CONTRACTORS CONVENIENCE ONLY. THERE MAY BE OTHER UTILITIES NOT SHOWN ON THESE PLANS. THE ENGINEER/SURVEYOR ASSUMES NO RESPONSIBILITY FOR THE LOCATIONS SHOWN AND IT SHALL BE THE CONTRACTOR'S RESPONSIBILITY TO VERIFY ALL THE UTILITIES WITHIN THE LIMITS OF THE WORK. ALL DAMAGE MADE TO THE (E) UTILITIES BY THE CONTRACTOR SHALL BE THE SOLE RESPONSIBILITY OF THE CONTRACTOR. CALL 811 BEFORE YOU DIG IT'S THE LAW MODUS PROJECT MANAGER: MODUS, LLC 240 STOCKTON ST., 3RD FLOOR SAN FRANCISCO, CA 94108 PHONE: (415) 989.1102 EMAIL: VERIZONPOLYGONTEAM@MODUS-CORP.COM CONSTRUCTION/IMPLEMENTATION MANAGER: MODUS, LLC 240 STOCKTON ST., 3RD FLOOR SAN FRANCISCO, CA 94108 PHONE: (415) 989.1102 EMAIL: VERIZONPOLYGONTEAM@MODUS-CORP.COM A&E PROJECT MANAGER: MODUS, LLC 240 STOCKTON ST., 3RD FLOOR SAN FRANCISCO, CA 94108 PHONE: (415) 989.1102 EMAIL: VERIZONPOLYGONTEAM@MODUS-CORP.COM APPLICANT: VERIZON WIRELESS 2785 MITCHELL DRIVE, SUITE 9 WALNUT CREEK, CA 94598 CONTACT: CHRIS MOLLER PHONE: (925) 339.2778 EMAIL: CHRIS.MOLLER@VERIZONWIRELESS.COM LAND USE PLANNER: MODUS, LLC 240 STOCKTON ST., 3RD FLOOR SAN FRANCISCO, CA 94108 PHONE: (415) 989.1102 EMAIL: VERIZONPOLYGONTEAM@MODUS-CORP.COM SITE ACQUISITION: MODUS, LLC 240 STOCKTON ST., 3RD FLOOR SAN FRANCISCO, CA 94108 PHONE: (415) 989.1102 EMAIL: VERIZONPOLYGONTEAM@MODUS-CORP.COM (IFO) 20306 CLIFDEN WAY CUPERTINO, CA 95014 D-3 POLE SPECS C-1 A-2 ELEVATIONS SITE ID: SITE TYPE: POLE #: COUNTY: PSLC: (IFO) 20306 CLIFDEN WAY CUPERTINO, CA 95014 D-4 CITY STANDARD DETAILS SF_CUPERTINO_024 SF_CUPERTINO_024 LIGHT POLE 5301 SANTA CLARA 417718 (IFO) 20306 CLIFDEN WAY SITE DocuSign Envelope ID: 3D64C662-089D-4E8D-A5A5-6AE4C3B8DEECDocuSign Envelope ID: 4DFFE21A-F701-48B4-9895-C513A850B8C0 S/L S/L S/L O/H O/H O/H O/H O/H S/LS/LS/L S/L S/L S/L S/L FIBERFIBERFIBERFIBER FIBERO/H O/H O/H O/H O/H O/H O/H O/H DRAWN BY: CHECKED BY: IT IS A VIOLATION OF THE LAW FOR ANY PERSON, UNLESS THEY ARE ACTING UNDER THE DIRECTION OF A LICENSED PROFESSIONAL ENGINEER, TO ALTER THIS DOCUMENT REV DATE DESCRIPTION MODUS, LLC 240 STOCKTON ST., 3RD FLOOR SAN FRANCISCO, CA 94108 APPROVED BY:LJB VERIZON WIRELESS 2785 MITCHELL DRIVE, SUITE 9 WALNUT CREEK, CA 94598 BPM APE 0 08/03/20 100% CD SF_CUPERTINO_024 CUPERTINO, CA 95014 (IFO) 20306 CLIFDEN WAY 1 11/19/20 100% CD PLAN CHECK 2 12/09/20 100% CD PLAN CHECK A-1 SITE PLAN 1ENLARGED SITE PLAN N SITE PLAN2 N 1/16"=1'-0" SCALE 1/2"=1'-0" SCALE ELECTRICAL LINE STREET LIGHT LINE E S/L FIBER LINE(S)FIBER LEGEND (E ) S I D E W A L K 1&2 A-3 1&2 A-2 (N) LOCATION OF VERIZON WIRELESS CANISTER ANTENNA IN FRP SHROUD MOUNTED ON LIGHT POLE (N) LOCATION OF VERIZON WIRELESS EQUIPMENT MOUNTED ON LIGHT POLE (E) LIGHT POLE & FOUNDATION TO BE REMOVED. (N) LIGHT POLE AND FOUNATION TO BE INSTALLED IN PLACE RIGHT O F W A Y (E) CURB & GUTTER (E) SHRUB (TYP.) 1 0 ' - 9 " B A C K O F C A B I N E T T O R O W L I N E (N) STEEL MAST ARM (N) LUMINAIRE N2 N1 NC2 NC3 AZIMUTH 90° AZIMUTH 270° A.P.N.: 36936026 N C 1 NC4 REMOVE AND REPLACE CONCRETE, APPROX. 25 SQ. FT. AT APPROXIMATE LIMITS TO MATCH EXISTING ADJACENT ELEVATIONS. REPLACE WHOLE FLAGS, NOT PARTIAL 20306 CLIFDEN WAY CLIFDEN WAY (N) 2'-6" x 4'-0" x 6" THICK CONCRETE CAP PER CITY STANDARDS (E) OVERHEAD UTILITY LINE TO BE REMOVED NOTE: 1. FIBER PULLBOX EXACT LOCATION TO BE VERIFIED IN FIELD 2. CITY PULLBOX AT POC TO BE WITHIN 10' OF PG&E VAULT 3. UPON COMPLETION OF CONSTRUCTION, RESTORE LANDSCAPE AND IRRIGATION TO LIKE OR BETTER CONDITION, TEST IRRIGATION. 4. UPON COMPLETION OF CONSTRUCTION, NOTIFY THE CITY OF NEW STREETLIGHT INSTALLATION SO THAT NEW BADGE ID NUMBER CAN BE PLACED BY THE CITY ONTO THE NEW STREETLIGHT POLE. 5. FIBER PULLBOX NOT TO BE PLACED IN WINGS OF HC RAMP, NO EXCAVATION TO OCCUR WITHIN RAMP 2 A-1 MI C H A E L C T CLIFDEN WAY ENLARGED SITE PLAN (N) LOCATION OF VERIZON WIRELESS CANISTER ANTENNA AND EQUIPMENT (E) BUILDING A.P.N.: 36936026 (E) UTILITY POLE (N) ELECTRICAL SERVICE N1 CITY SERVICE BOX, SEE NOTE 2 (E) SHRUB (TYP.) 20306 CLIFDEN WAY A.P.N.: 36935041 20305 CLIFDEN WAY A.P.N.: 36937002 AN T O I N E T T E D R (E) CURB & GUTTER RI G H T O F W A Y RIG H T O F W A Y RIGHT OF WAYRIGHT OF WAY RIGHT OF WAY (E ) SI D E W A L K (E) SIDEWALK A.P.N.: 20328 20328 MICHAEL COURT (E) OVERHEAD UTILITY LINE TO BE REMOVED BY OTHERS (N) CONDUIT TRENCH PER DETAIL 1/D-4, (75'±) (N) CONDUIT TRENCH PER DETAIL 1/D-4, (10'±) (N) PG&E TRENCH, SEE DETAIL 8/E-3 NOTE: CARRIER GROUND WIRE TO BE LABELED IN FIELD Salvage removed plants for replanting after construction, or return to owner. Label carrier gnd line in City box. DocuSign Envelope ID: 3D64C662-089D-4E8D-A5A5-6AE4C3B8DEECDocuSign Envelope ID: 4DFFE21A-F701-48B4-9895-C513A850B8C0 SHUTDOWN DRAWN BY: CHECKED BY: IT IS A VIOLATION OF THE LAW FOR ANY PERSON, UNLESS THEY ARE ACTING UNDER THE DIRECTION OF A LICENSED PROFESSIONAL ENGINEER, TO ALTER THIS DOCUMENT REV DATE DESCRIPTION MODUS, LLC 240 STOCKTON ST., 3RD FLOOR SAN FRANCISCO, CA 94108 APPROVED BY:LJB VERIZON WIRELESS 2785 MITCHELL DRIVE, SUITE 9 WALNUT CREEK, CA 94598 BPM APE 0 08/03/20 100% CD SF_CUPERTINO_024 CUPERTINO, CA 95014 (IFO) 20306 CLIFDEN WAY 1 11/19/20 100% CD PLAN CHECK 2 12/09/20 100% CD PLAN CHECK A-2 EXISTING & PROPOSED ELEVATIONS 12PROPOSED ELEVATIONEXISTING ELEVATION 1/2"=1'-0" SCALE 1/2"=1'-0" SCALE EXISTING SURFACE 0'-0" AGL EXISTING SURFACE 0'-0" AGL T.O. (N) RADIO UNITS 15'-0" AGL B.O. (N) CABLE SHROUD 12'-1" AGL 4 D-2 (N) FOUNDATION (N) DISCONNECT / SMART METER (N) (1) RRUS 32s W/ PSU-08 AND CABLE SHROUD B.O. (N) DISCONNECT / SMART METER 7'-0" AGL (N) LIGHT POLE (N) LUMINAIRE (N) NOTICE SIGNAGE, TYP. OF (1) FACING STREETSIDE 12 D-1 (N) 6'-0" MAST ARM T.O. (N) SIGN 14'-8" AGL B.O. (N) SIGN 13'-2" AGL (N) RED "BICYCLE WRONG WAY" SIGNAGE 7 E-3 T.O. (N) STEEL LIGHT POLE 30'-0" AGL T.O. (E) LIGHT SENSOR 32'-0" AGL RAD CENTER OF (N) 5G ANTENNA 31'-7" AGL T.O. (N) CONCEALMENT SHROUD 35'-6" AGL RAD CENTER OF (N) CANISTER ANTENNA 34'-3" AGL (N) (2) 5G ANTENNAS IN FRP SHROUD 6 D-1 (N) VERIZON WIRELESS CANISTER ANTENNA 4 D-1 (N) FRP CONCEALMENT SHROUD 1 D-1 (N) (2) TWIN DIPLEXERS IN FRP SHROUD 3 D-1 T.O. (N) NOTICE SIGNAGE 25'-2" AGL T.O. (N) DISCONNECT / SMART METER 8'-9" AGL 5 D-1 8 D-1 10 D-1 10 E-3 11 D-1 7 D-1 4 E-3 3 E-3 PORT HOLE LOCATION FOR DISCONNECT 1 D-2 PORT HOLE LOCATION FOR RRUS 1 D-2 9 D-1 5 E-3 PORT HOLE LOCATION FOR RRUS 1 D-2 5 D-1 8 D-1 10 D-1 (N) (1) RRUS 32s W/ PSU-08 AND CABLE SHROUD 5 E-3 T.O. (N) RADIO UNIT 18'-11" AGL B.O. (N) CABLE SHROUD 16'-0" AGL NOTES: 1. ALL NEW ANTENNAS, BRACKETS, AND OTHER EQUIPMENT WILL BE PAINTED TO MATCH LIGHT POLE. 2. ALL EXISTING SIGNAGE TO BE RELOCATED SHALL BE FASTENED USING 1/2" STEEL BANDING. (E) FOUNDATION TO BE REPLACED (E) LIGHT POLE TO BE REPLACED (E) LUMINAIRE 10'-9"± BACK OF POLE TO ROW LINE (E) T.O. LIGHT SENSOR 32'-0" AGL (E) T.O. POLE 30'-0" AGL T.O. (E) ROAD SIGN 10'-8" AGL B.O. (E) ROAD SIGN 10'-0" AGL (E) LIGHT ARM 28'-10" AGL (E) LIGHT ARM SUPPORT 26'-5" AGL (E) SECONDARY (TO BE REMOVED) 29''-6" AGL (E) ROAD SIGN (E) LIGHT ARM 28'-10" AGL T.O. (E) ROAD SIGN 10'-8" AGL B.O. (E) ROAD SIGN 10'-0" AGL 10'-9"± BACK OF POLE TO ROW LINE DocuSign Envelope ID: 3D64C662-089D-4E8D-A5A5-6AE4C3B8DEECDocuSign Envelope ID: 4DFFE21A-F701-48B4-9895-C513A850B8C0 Certificate Of Completion Envelope Id: 3D64C662089D4E8DA5A56AE4C3B8DEEC Status: Completed Subject: Please DocuSign: Cupertino 024_Encroachment Agreement.pdf Source Envelope: Document Pages: 7 Signatures: 0 Envelope Originator: Certificate Pages: 5 Initials: 14 BRYAN MCCAFFERY AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (UTC-08:00) Pacific Time (US & Canada) 92 Bay Street Glens Falls, NY 12801 modusdocusign@modusllc.com IP Address: 24.8.148.187 Record Tracking Status: Original 3/16/2021 3:30:30 PM Holder: BRYAN MCCAFFERY modusdocusign@modusllc.com Location: DocuSign Signer Events Signature Timestamp Chad Mosley chadm@cupertino.org Security Level: Email, Account Authentication (None) Signature Adoption: Drawn on Device Using IP Address: 67.164.60.110 Sent: 3/16/2021 3:31:27 PM Viewed: 3/16/2021 4:37:18 PM Signed: 3/16/2021 4:54:08 PM Electronic Record and Signature Disclosure: Accepted: 1/8/2021 11:03:58 AM ID: cf965389-d53e-4e7e-9e57-3e9c6593663d Marlene Dehlinger Dehlinger@smwlaw.com Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 52.39.49.65 Sent: 3/16/2021 3:31:28 PM Viewed: 3/17/2021 11:56:03 AM Signed: 3/17/2021 11:59:48 AM Electronic Record and Signature Disclosure: Accepted: 3/17/2021 11:56:03 AM ID: 637c3337-4420-497c-bf60-54b1a0aa6c3d In Person Signer Events Signature Timestamp Editor Delivery Events Status Timestamp Agent Delivery Events Status Timestamp Intermediary Delivery Events Status Timestamp Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp Steve Pagan stevep@cupertino.org Security Level: Email, Account Authentication (None) Sent: 3/16/2021 3:31:28 PM Viewed: 3/16/2021 4:28:45 PM Electronic Record and Signature Disclosure: Not Offered via DocuSign Witness Events Signature Timestamp DocuSign Envelope ID: 4DFFE21A-F701-48B4-9895-C513A850B8C0 Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 3/16/2021 3:31:28 PM Certified Delivered Security Checked 3/17/2021 11:56:03 AM Signing Complete Security Checked 3/17/2021 11:59:48 AM Completed Security Checked 3/17/2021 11:59:48 AM Payment Events Status Timestamps Electronic Record and Signature Disclosure DocuSign Envelope ID: 4DFFE21A-F701-48B4-9895-C513A850B8C0