21-033 Pervious Pavement Maintenance Agreement and Access Easement for Stormwater Management, 10310 North Foothill Boulevard, APN 326-15-096RECORDED AT THE REQUEST OF
And
WHEN RECORDED RETURN TO:
City Engineer
City of Cupertino
10300 Torre Avenue
Cupertino, CA 95014
The undersigned hereby declares this instrument,
to be exempt from Documentary Transfer Tax )
(CA Rev. & Tax Code § 11922 and S.F. Bus. & )
Tax Reg Code § 1105) and recording fees per )
Government Code §27383 and §27388.1. )
24895391
Regina Alcomendras
Santa Clara County - Clerk -Recorder
03/29/2021 11:19 AM
Titles: 1 Pages: 14
Fees: $0.00
Taxes: $0
Total: $0.00
APN: 326-15-096 SPACE ABOVE FOR RECORDER'S USE ONLY
PERVIOUS PAVEMENT MAINTENANCE AGREEMENT AND ACCESS EASEMENT
FOR STORMWATER MANAGEMENT
10310 North Foothill Boulevard, Cupertino CA 95014
APN 326-15-096
THIS PERVIOUS PAVEMENT MAINTENANCE AGREEMENT ("Agreement") is
made and entered into this Z 5 day of -SWU 2021, by D&B Legacy, LLC, a California
limited liability company, ("Developer"), and the City of Cupertino ("City"), each a "party" and
collectively, the "parties."
RECITALS
The following recitals are a substantive portion of this Agreement:
A. The improvements that comprise a 15-unit apartment called "North Foothill Boulevard" is
located at 10310 N. Foothill Boulevard in the City of Cupertino ("City"), County of Santa Clara,
State of California. Developer owns the Project.
B. The real property on which the Project is or will be built is described in Exhibit A
("Property"). Developer owns the Property ("Property").
C. City owns or holds easements for street purposes on property adjacent to the Project and
Property ("City Property"). The Property and the City Property shall be referred to collectively as
the "Properties."
D. Developer proposes to construct a pervious pavement system consisting of a permeable
pavement surface layer and one or more underlying aggregate layers, and related storm drainage
systems ("Pervious Pavement") that collects stonnwater through voids in the pavement surface and
stores water in the aggregate base reservoir to facilitate infiltration of stormwater into the soils
beneath the pavement. The area and design detail of the Pervious Pavement is shown in Exhibit B.
E. The purpose of this Agreement is to allocate the costs of inspection, maintenance, repair,
replacement, and removal of the Pervious Pavement and .to establish criteria and procedures for
maintenance, repair, replacement, and removal of the Pervious Pavement.
NOW, THEREFORE the parties hereto agree as follows:
1. Developer's Responsibility for Maintenance Repair Replacement, and Removal of
Pervious Pavement. Developer shall, at its sole cost and expense, design, construct, maintain,
repair, replace, and remove the Pervious Pavement as required by the Pervious Pavement
Maintenance Plan set forth in Exhibit C, including, but not limited to, the requirements that
Developer maintain the Pervious Pavement (a) in excellent, like new condition, (b) useable under
all weather conditions, (c) in a condition that meets the standards, specifications, and conditions
required by City in the plans and specifications for the original construction of the Pervious
Pavement on file with the City, and (d) in accordance with all applicable laws and regulations,
including but not limited to City's Stormwater Pollution Prevention and Watershed Protection
Ordinance, Ordinance No. 1571.
2. Inspection and Maintenance Report. Developer shall conduct at least one inspection of
the Pervious Pavement between August 1st and September 30 each year and additional
inspections as necessary to comply with the Pervious Pavement Maintenance Plan. No later than
October 15 of each year, Developer shall submit to the City Public Works Director, or such other
member of the City staff as directed by the Public Works Director, an Inspection and
Maintenance Report under penalty of perjury and in the format required by Exhibit C or such
other format as City may require from time to time. The Inspection and Maintenance Report shall
identify all inspection, maintenance, repair, replacement, and removal tasks performed during the
prior year and shall verify that inspection, maintenance, repair, replacement, and removal of the
Pervious Pavement has been conducted as required by this Agreement.
3. Qualified Personnel. Developer shall provide licensed, qualified personnel to perform the
inspection, maintenance, repair, replacement, and removal of Pervious Pavement required by this
Agreement.
4. Modifications of Pervious Pavement. Developer shall promptly modify, including
maintain, repair, replace, and remove, the Pervious Pavement as the City Engineer may reasonably
determine to be necessary to ensure that the Pervious Pavement continues to operate as originally
designed and approved and in accordance with the Pervious Pavement Maintenance Plan.
Developer may modify the Pervious Pavement only with prior written authorization by the City
Engineer or his or her designee.
5. Grant of Easement and City's Inspections. Developer grants to City a nonexclusive access
and maintenance easement ("Easement") permitting City and its employees, agents, contractors,
and consultants the right of ingress and egress to the Pervious Pavement from the existing streets
adjoining the Property and over the existing drives, walkways, and parking areas located on the
Property to inspect the Pervious Pavement to ensure that Developer constructs and is maintaining
the Pervious Pavement in accordance with the Pervious Pavement Maintenance Plan. City may use
the Easement to inspect the Pervious Pavement at reasonable times and shall provide not less than
forty-eight (48) hours advance written notice to Developer of City's intent to use the Easement,
except that in a case of an immediate threat to public health and safety, no prior notice shall be
required. City's use of the Easement shall be reasonable as provided in the Cupertino Municipal
Code sections 9.18.190 and 9.18.200.
2
6. Indemnity. To the fullest extent allowed by law, Developer shall indemnify, hold harmless,
and defend (with counsel acceptable to City) City, its City Council, boards and commissions,
officers, officials, agents, employees, consultants, refuse and recycling contractors, subcontractors,
and volunteers (collectively, "Indemnitees") from and against any liability, loss, damage, expense,
and cost (including reasonable legal fees and costs of litigation or arbitration), resulting from injury
to or death of any person, damage to property, or liability for other claims, stop notices, demands,
causes of actions, and actions (collectively, "Claims"), arising out of or in any way pertaining to,
or related to Developer's performance of its obligations under this Agreement or the design,
construction, use, maintenance, repair, replacement, or removal of the Pervious Pavement by
Developer or Developer's employees, officers, agents or independent contractors, except to the
extent a Claim is caused by the active or gross negligence or willful misconduct of an Indemnitee.
Developer's obligation to defend Indemnitees from Claims shall accrue immediately upon the filing
of any litigation against Indemnitees and shall not be contingent on a final determination in the
litigation that Indemnitees are not liable for the Claims.
7. Successors and Assigns. This Agreement shall inure to the benefit of and bind the
respective successors and assigns of Developer and City. This Agreement is for the exclusive
benefit of the parties and not for the benefit of any other person and shall not be deemed to have
conferred any rights, express or implied, upon or duties to any other person.
8. Covenants Running with the Land. Each and all easements, covenants, conditions, and
restrictions set forth in this Agreement are for the mutual benefit of the Properties and every portion
of each thereof. Each and all of the easements, covenants, obligations, conditions, and restrictions
set forth in this Agreement touches and concerns and shall affect, relate to, and run with the land
of each of the Properties and every portion of each thereof, and shall apply to and bind the
respective successors of the owners of each of the Properties and every portion of each thereof, for
the benefit of each of the other Properties. Each and all of the easements, covenants, obligations,
conditions, and restrictions set forth in this Agreement are imposed on each portion of and interest
in each of the Properties as mutual equitable servitudes in favor of each and all other portions of
and interests in the Properties and constitute covenants running with the land under applicable law,
including, without limitation, Section 1468 of the Civil Code of the State of California.
9. Attorney's Fees. In the event that any party institutes legal action or arbitration against the
other to interpret or enforce this Agreement, or to obtain damages for any alleged breach, the
prevailing party in the action or arbitration shall be entitled to reasonable attorneys' or arbitrators'
fees in addition to all other recoverable costs, expenses, and damages.
10. Further Documents. The parties shall execute further documents and instructions as shall
be necessary to fully effectuate the terms and provisions of this Agreement.
11. Entire Agreement. This Agreement constitutes the entire agreement of the parties with
respect to the subject matter contained herein and supersedes all prior agreements, whether written
or oral. There are no representations, agreements, arrangements, or undertakings, oral or written,
which are not fully expressed herein.
12. Severability. In the event any part or provision of this Agreement shall be determined to
be invalid or unenforceable under the laws of the State of California, the remaining portions of this
Agreement which can be separated from the invalid, unenforceable provisions shall, nevertheless,
continue in full force and effect.
3
13. No Waiver. The waiver of any covenant, condition, or provision contained herein shall not
be deemed to be a continuing waiver of the same or of any other covenant, condition, or provision
contained herein.
14. Recordation. This Agreement shall be recorded and shall be executed and acknowledged
in proper recordable form.
15. Amendment. This Agreement may be amended in whole or in part only by mutual written
agreement of the parties. Any amendment shall be recorded in Santa Clara County, California. If
any conflict arises between the provisions of any such amendment and any of the provisions of any
earlier document or documents, the most recently duly executed and recorded amendment shall be
controlling.
16. Governing Law. This Agreement shall be governed by and construed in accordance with
the laws of the State of California. Developer and City agree that all actions or proceedings arising
directly or indirectly under this Agreement shall be litigated in courts located within the County of
Santa Clara, State of California, and Developer and City agree that any service of process in such
action or proceeding may be made by personal service upon the other wherever the other may then
be located, or by certified or registered mail directed to the party at the address set forth in this
Agreement.
17. Counterparts. This Agreement may be executed in any number of counterparts, each of
which shall be deemed to be an original, but any number of which, taken together, shall constitute
one and the same instrument.
18. Relationship of the Parties. The subject of this Agreement is a private development with
neither Party acting as the agent of the other party in any respect. None of the provisions in this
Agreement shall be deemed to render City a partner in Developer's business, or joint venturer, or
member in any joint enterprise with Developer.
19. Notices. A notice or communication under this Agreement by either party to the other shall
be sufficiently given or delivered if personally delivered or dispatched by registered or certified
mail, postage prepaid, return receipt requested or reputable overnight courier service and addressed
as follows:
To City. In the case of a notice or communication to City:
City Engineer
City of Cupertino
10300 Torre Ave.
Cupertino, CA 95014
To Developer. And in the case of a notice or communication sent to Developer:
D&B Legacy, LLC
10450 Serra St.
Cupertino, CA 95014
Attention: Robert Adzich
n
Executed the day and year first above written.
DEVELOPER:
D & B Legacy, LLC
A California limited liability company
By VnH J (notary acknowledgement attached)
Robert Adzich
Managing Manager
Date
i����7o'L
CITY OF CUPERTINO
By
Roger L
Director of Public Works
Date C .�
Approved as to Form
City Attorney
(notary acknowledgement attached)
5
EXHIBIT A
LEGAL DESCRIPTION
Real property located in the State of California, County of Santa Clara, City of Cupertino,
described as follows:
Beginning at the Northernmost corner of that certain 12.31 acre tract of land described in the Deed
from Richard J. Wilson, et al, to California Pacific Title Insurance Company, a Corporation, dated May
12,1960, recorded May 13,1960 in Book 4794 Official Records, Page 227, Santa Clara County
Records, in the Easterly line of Mountain View -Stevens Creek Road; thence from said point of
beginning South 4° 39' 45" East along the said Easterly line of Mountain View -Stevens Creek Road
for a distance of 408.12 feet; thence at right angles North 850 20' 15" East 145.00 feet; thence North
470 59' 40" East 119.21 feet to a point in the Northeasterly line of said 12.31 acne tract; thence
Northwesterly along the Northeasterly line of said 12.31 acre tract for the two following courses and
distances; North 42" 00 20" West 29.50 feet and North 400 03' West 383.14 feet to the point of
beginning.
Excepting therefrom:
That portion thereof conveyed to the County of Santa Clara by that certain Dead recorded October 27,1967
in Book 7907 Page 690 of Official Records and by Deed recorded October 27,1967 in Book 7907 Page
694 of Official Records, and being more particularly described as fellows:
Beginning at a point in the Easterly line of Foothill Boulevard, formerly Mountain View and Stevens
Creek Road (40.00 feet wide) from which a granite monuanent at an angle point in the center line of said
Foothill Boulevard marking the most Westerly comer of that certain 35.00 acne parcel of land shown on
the Map entitled "Map showing the property of Muni F. Eaton, etc." which Map was filed for record In the
Office ofthe Recorder ofthe County of Santa Clara, State ofCalifornia on January 3 1, 1946 in Book 9 of
Maps, at Page ' 14 bars North 39017 47' West, 34.53 feet; thence from said point of beginning along
the Northeasterly line of that certain 12.31 acre tract of land described in the Deed to California Pacific
Title Inse mce Company, which deed was filed for record in the office of the above said Recorder on
May 13,1960 in Book 4794 ofOfficial Records, at Page 227 South 39' 174T' East, 94.56 feet; thence
along the arc of a curve to the right from a tangent which bears South 0° 4342" West; with a radius of
5455.00 feet, through a coal angle of 3° 28' 58", an arc distance of 331.59 feet to a point in the Northerly
line of Tract No. 2769 La Cresta Unit No. 2, the Map of which was filed for record in the office of the
above said Recorder on July 11,1962 in Book 149 of Maps, at Page 23, distant along said Northerly
line North 860 06' 13" East; 38.09 feet from the Easterly line of Foothill Boulevard (40.00 feet wide),
thence South 860 06' 13" West, 38.09 feet to said Easterly line; thence along said Easterly line North 30 53,
47" West, 408,20 feet to the point of beginning.
APN: 326-15-0%
EXHIBIT B
6" PCC VERTICAL
CURB (TIP)
SEE DETAIL
2
1
WALL SUBDRAIN DETAILS (TYP)
CONNECT TO CLOSEST S.D.. LINE
SCARIFY AND COMPACT NATIVE
MATERIAL TO 95% COMPACTION,
SLOPE SUBGRADE 0 2% MIN.
TO SUBDRAIN.
co
"v v
DRAIN ROCK
MIRAFI 140N FILTER
FABRIC OR AN
4" PERF. PVC
APPROVED EQUAL
(PERFORATIONS
18»
FACING DOWN)
DRIVEWAY
SUBDRAIN
DETAIL
N.T.S.
NOTE-
4- PVC PIPE W/0 SLOPE IS ASSUMED
TO BE AT 2% MINIMUM.
6" PVC PIPE W/0 SLOPE IS ASSUMED
TO BE AT 1% MINIMUM.
NOTE: RAINWATER LEADER PIPES SHALL BE
3" PVC ® SLOPE � 2%
GRAPHIC SCALE
10 0 5 10 20 40
( IN FEET
1 inch = 10 ft.
20
D/W—INTERLOCKING PAVERS
SLOPE VARIES 27- (TYP)-10% MAX.
W
TYPICAL
ON -SITE DRIVEWAY DETAIL
N.T.S.
NOTE, 1
CROSSM
TO CUR,
OF ALP,
FOOTHIL
I �
PROPOSED GARAGE
TYPICAL DRIVEWAY AT GARAGES
WHERE DRIVEWAY IS SLOPING
N.T.S.
� oo v � K
`L6�
;
5
-,_} , \ NOTE
IOTE: SHORING FOR RETAINING EXHIBIT B B CLl
IALLS SHALL BE BY SEPARATE'
SIDD
IERMI T. NOTE
WILL
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EXHIBIT B
PERVIOUS PAVER
V AS
_AN
I" HOLE IN BOTTOM
!LOW WATER TO DRAIN
12"-2" WASHED CRUSTED STONE
DING COMPACTED TO 90% REL. COMP.
PAVER DETAIL
N.T.S.
)UTLET
VN
_CAUTION NECESSARY
6"
VATED WITH SOIL OR SILT
P.C.C. FLUSH CURB
ANDSCAPE IS COMPLETED.
TOOLED GROOVE
INTERLOCKING PAVER
WALKWAY* 29
�—
SEE PAVER DETAIL o
00000000
O00
C
E TA I L POUR CURB SEPARATE OR/
MONOLITHIC WITH SIDEWALK
INTERLOCKING PAVERS*
00 O — SEE PAVER DETAIL
l O DOO
6" SCARIFY AND
COMPACT TO 95.E
REL. COMPACTION
2
2
/ 2
ALTERNATE
SHOULDER
® DRIVEWAY
a
STRES!
EXHIBIT C
Pervious Pavement Maintenance Plan
Project Address: 10310 N Foothill Blvd, Cupertino
Assessor's Parcel No.: 326-15-096
Property Owner: D&B Legacy, LLC
Designated Contact: Robert Adzich Phone No.: 408-234-4835
Designated Contact's Email Address: robertadzich(a)_me.com
Mailing Address: 10450 Serra St, Cupertino CA
The property contains square feet of pervious paving area(s), located as described below and as shown in Exhibit B.
I. Routine Maintenance Activities
Types of pervious pavement include pervious concrete, porous asphalt, and permeable interlocking concrete pavement (PICP),
concrete grid pavers, and plastic reinforcement grid pavers. The principal maintenance objective is to prevent sediment buildup
and clogging, which reduces infiltration capacity and pollutant removal efficiency. Routine maintenance activities, and the
frequency at which they will be conducted, are shown in Table 1.
Table 1
Routine Maintenance Activities for Pervious Paving Areas
No.
Maintenance Task
Frequency of Task
1
Check for sediment and debris accumulation. Prevent soil from
Two to four times annually
washing or blowing onto the pavement. Do not store sand, soil, mulch
or other landscaping materials on pervious pavement surfaces.
2
Conduct preventative surface cleaning, using commercially available
Two to four times annually
regenerative air or vacuum sweepers, to remove sediment and
debris.
3
Inspect for any signs of pavement failure. Repair any surface
Two to four times annually
deformations or broken pavers. Replace missing joint filler in PICP.
4
Check for standing water on the pavement surface within 30 minutes
Two to four times annually
after a storm event.
5
Inspect underdrain outlets and cleanouts, preferably before the wet
Two to four times annually
season. Remove trash/debris.
6
Remove sediment and debris accumulation on pervious pavement.
As needed
7
Remove weeds. Mow vegetation in grid pavements (such as turf
As needed
block) as needed.
Pervious Pavement Maintenance Plan - Page 1
Table 1
Routine Maintenance Activities for Pervious Paving Areas
No.
Maintenance Task
Frequency of Task
8
Perform restorative surface cleaning with a vacuum sweeper, and/or
As needed
reconstruction of part of the pervious surface to restore surface
permeability as needed. Replenish aggregate in PICP joints or grids
as needed after restorative surface cleaning.
9
Power washing with simultaneous vacuuming also can be used to
As needed
restore surface infiltration to highly clogged areas of pervious
concrete, porous asphalt or PICP, but is not recommended for grid
pavements.
10
Inspect pervious paving area using the attached inspection checklist.
Quarterly or as needed
II. Use of Pesticides
Do not use pesticides or other chemical applications to control weeds or unwanted growth near pavement or between pavers.
III. Vector Control
Standing water shall not remain in the treatment measures for more than five days, to prevent mosquito generation. Should any
mosquito issues arise, contact the Santa Clara Valley Vector Control District (District). Mosquito larvicides shall be applied only when
absolutely necessary, as indicated by the District, and then only by a licensed professional or contractor. Contact information for the
District is provided below.
Santa Clara Valley Vector Control District
1580 Berger Dr.
San Jose, California 95112
Phone: (408) 918-4770 / (800) 675-1155 - Fax: (408) 298-6356
www.sccgov.org/portal/site/vector
IV. Inspections
The attached Pervious Pavement Inspection and Maintenance Checklist shall be used to conduct inspections monthly (or as
needed), identify needed maintenance, and record maintenance that is conducted.
Page 2
Pervious Pavement
Inspection and Maintenance Checklist
Property Address: 10310 N Foothill Blvd, Cupertino
Treatment Measure No.: Date of Inspection:
Inspector(s):
Property Owner: D&B Legacy, LLC
Type of Inspection: I Monthly I Pre -Wet Season
After heavy runoff I_ End of Wet Season
I Other:
Defect
Conditions When Maintenance Is
Maintenance
Comments (Describe maintenance
Results Expected When
Needed
Needed? (Y/N)
completed and if needed maintenance was
Maintenance Is Performed
not conducted, note when it will be done)
1. Standing Water
Water stands in the pervious
There should be no areas of
pavement and does not drain within
standing water once a storm event
30 minutes after storm event
has ceased. Restorative surface
cleaning with a vacuum sweeper
and/or reconstruction of part of the
pervious surface may be required.
2. Trash, or
Trash, sediment or debris
Trash and debris removed from
Sediment and
accumulated on pervious pavement
pervious pavement and disposed of
Debris
properly. Ensure adjacent areas do
Accumulation
not contribute to sediment and
debris accumulation on pervious
pavement.
3. Damage
Surface deformation or broken pavers
Restore surface or reconstruct
pavement as necessary to correct
failed pavement; no deformation or
broken pavers.
4. Vegetation
Weeds growing on pervious
Remove weeds from pavement; No
pavement
weeds on pervious pavement.
5. Underdrain
Water accumulates due to
Clean underdrain outlets and
Outlets
trash/sediment accumulation in
cleanouts; No standing water
outlets.
observed.
6. Miscellaneous
Any condition not covered above that
Meets the design specifications.
needs attention for the pervious
pavement to function as designed.
Page 3
CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to
which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of w�a cl"Orc�—
On S A h ��' �"�� before me, KaU I , Notary Public,
'(Her( f the officer)
personally appeared kcb e TA
JZIC�.
who proved to me on the basis of satisfactory evidence to be the person(�>whose name�Ois/;; ' ubscribed to
the within instrument and acknowledged to me that he/0&>1"y1 executed the same in his/Y4»'t� authorized
capacity(kSj; and that by his/W/t#eir signature, f s�n the instrument the person�W, or the entity upon behalf of
which the person acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph
is true and correct.
WITNESS my hand and official seal. RAVI IYER
Notary Public - California
< ` ? Santa Clara County n
F Commission # 22299E2
(Notary Seal) My Comm. Expires Apr 27, 2022
Signature of Notary Public /
ADDITIONAL OPTIONAL INFORMATION
DESCRIPTION OF THE ATTACHED DOCUMENT
/�
e r V I Q v S f o m p° 'ra 1 b) To w k e r �� rt'e w,(L
(Title or description of attached document)
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Number of Pages Document Date D! /,J2� ) I_� I
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(Title)
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which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of Santa Clara
On March 18, 2021
before lne, Lauren Sapudar
(Here insert name and title of the officer)
personally appeared Roger Lee
Notary Public,
who proved to me on the basis of satisfactory eviden to be the erso (s) whose rE*s)&/are subscribed to
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I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph
is true and correct.
LAUREN SAPUDAR
Notary Public • California
WI S my hand and official seal. Santa Clara County
Commission N 2247155
My Comm. Expires Jun 22, 2022
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(Additional information)
CAPACITY CLAIMED BY THE SIGNER
❑ Individual (s)
❑ Corporate Officer
(Title)
❑ Partner(s)
❑ Attorney -in -Fact
❑ Trustee(s)
❑ Other
INSTRUCTIONS FOR COMPLETING THIS FORM
Any acknowledgment completed in California must contain verbiage exactly as
appears above in the notary section or a separate acknowledgment form must be
properly completed and attached to that document. The only exception is if a
document is to be recorded outside of California. In such instances, any alternative
acknowledgment verbiage as may be printed on such a document so long as the
verbiage does not require the notary to do something that is illegal for a notary in
California (i.e. certifying the authorized capacity of the signer). Please check the
document carefully for proper notarial wording and attach this form if required.
• State and County information must be the State and County where the document
signer(s) personally appeared before the notary public for acknowledgment.
• Date of notarization must be the date that the signer(s) personally appeared which
must also be the same date the acknowledgment is completed.
• The notary public must print his or her name as it appears within his or her
commission followed by a comma and then your title (notary public).
• Print the name(s) of document signer(s) who personally appear at the time of
notarization.
• Indicate the correct singular or plural forms by crossing off incorrect forms (i.e.
he/she/they, is /are ) or circling the correct forms. Failure to correctly indicate this
information may lead to rejection of document recording.
• The notary seal impression must be clear and photographically reproducible.
Impression must not cover text or lines. If seal impression smudges, re -seal if a
Sufficient area permits, otherwise complete a different acknowledgment form.
• Signature of the notary public must match the signature on file with the office of
the county clerk.
Additional information is not required but could help to ensure this
acknowledgment is not misused or attached to a different document.
Indicate title or type of attached document, number of pages and date.
Indicate the capacity claimed by the signer. If the claimed capacity is a
corporate officer, indicate the title (i.e. CEO, CFO, Secretary).
• Securely attach this document to the signed document
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