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01-056 Improv. Agree., NagelRECORDING REQUESTED BY City of Cupertino WHEN RECORDED MAIL TO City Clerk's Office City of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 NO FEE INACCORDANCE WITH GOY. CODE 6103 (SPACE ABOVE THIS LINE FOR RECORDER'S USE) CERTIFICATE OIL COMPLETION AND NOTICE OF ACCEPTANCE OF COMPLETION a3~3 ~I~~XI~~~~~WI~~ Titles~l / Pages 3 Fees....* No Fees Taxes... Copies.. ___ AMT PAID BRENDA DAVIS SANTA CLARA COUNTY RECORDER Recorded at the request of City RDE # 009 7/19/2002 1 135 AM MICHAEL & MALKA NAGEL ~`' 10180 CAMIwO VISTA `,.~~ APN 342••14-057 G Original O For Fast Endorsement ~.-.. tv CITY OF CUPEI~TINO CERTIFICATE OF COMPLETION ANL~ City Hall 10300 Torre Avenue Cupertino, CA 95014-3255 (408) 777-3354 FAX (408) 777-3333 PUBLIC WORKS DEPARTMENT NOTICE OF ACCEPTAN~~E 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, d~~ hereby certify that the municipal improvements in conjunction with the following project: MICHAEL & MALKA NAGEL,10180 CAMINO VISTA APN 342-14-057 have been completed in accordance with the approved improvement plans and acceptance of completion was ordered on July 15, 2002. u, u Director of Public Works and ('.ity Engineer of the City of Cupertino Date: July 16, 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 they laws of the State of California, that the foregoing is true and correct. Executed on the 17th day of July 2002 at Cupertino, California. ~~~~~ Administrative Clerk City of Cupertino RECORDING REQUESTED BY City of Cupertino WHEN RECORDED MAIL TO City Clerk's Office City of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 I~~~'~h~Y~~~~M~ Titles~l /Pages Fees.... No Fees Taxes... Copies.. AMT PAID 3 E~RENDA DAV I S SANTA CLARA COUNTY RECORDER F:ecorded at the request of C. i t y RDE # 009 7/19/2002 1 135 AM NO FEE INACCORDANCE WITH GOV. CODE 6103 (SPACE ABOVE THIS LINE FOR RECORDER'S USE) CERTIFICATE OIL COMPLETION AND NOTICE OF ACCEPTAPfCE OF COMPLETION TRAFFIC SIGNAL MODIFICATIOPJ PROJECT AT BLANEY AVENUE AND STEVENS CREEK BOULEVA-RD, PROJECT N0.2001-01 Original O For Fast Endorsement ~F.. '~% CITY OF CUPEI~TINO City Hall 10300 Torre Avenue Cupertino, CA 95014-3255 (408) 777-3354 FAX (408) 777-3333 PUBLIC WORKS DEPARTMENT CERTIFICATE OF COMPLETION ANL~ NOTICE OF ACCEPTANI~E OF COMPLETION TRAFFIC SIGNAL MODIFICATION PROJECT AT BLANEY AVENUE AND STEVENS CREEK BOULEVA]ltD, PROJECT N0.2001-O1 NOTICE IS HEREBY GNEN THAT I, Ralph A. Qualls, Jr., Director of Public Works and City Engineer of the City of Cupertino, California, do hereby certify that the work and improvements hereinafter described in the contract for doing which was entered into by and between the City of Cupertino and Republic Electric on January 8, 2002., in accordance with the plans and specifications for said work, have been completed to my satisfaction and acceptance of completion was ordered by the City Council on July 16, 2002. That said work and improvements consisted of furnishing all labor, materials tools, and equipment required to complete said project, all as more particularly described in the plans and specifications for said project. `_~,,,~,~,~ u u l;~irector of Public Works and City Engineer of the City of Cupertino Date: July 16, 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 17th day of July 2002 at Cupertino, California. ~ /~IG~ Administrative Clerk City of Cupertino Ol, b AGREI~MENT 10180 Camino Vista Drive APN 34:2-14-057 This AGREEMENT made and entered into this ~- day of ~'z'~ 2001, by and between the CITY OF CUPERTINO, a municipal corpor~~tion of the State of California, hereinafter designated as CITY, and Michael Nagel and M:alka Nadel, Husband and Wife, as Joint Tenants hereinafter designated as DEVELOPEF:S. 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 Edward Hahamian, R.C.E., a tnze copy of which improvement plans and specifications are on file in the office of the City Engineer of Cupertino; and WHEREAS, the same are incorporated herein by reference, the same as though set out in full; NOW, THEP.EFOF.E, 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 l of 11 File No.: 52,287 WHEREAS, pursuant to the provisions of this E,GREEMENT, 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: On-Site: $9,200 110-2211 Off-Site: $6,650 PART B. Labor and Material Bond: On-Site $9,200 110-2211 Off-Site $6,650 PART C. Checking and Inspection Fee: $2,130 110-4538 PART D. Indirect City Expenses: N/A PART E. Development Maintenance Depo:;it: $1,000 110-2211 PART F. Storm Drainage Fee: Basin 2 $284 Account #: 215-4072 PART G. One Year Power Cost: N/A 110-4537 PART H. Street Trees N/A PART I. Map Checking Fee: N/A 110-4539 PART J. Park Fee: ZONE II N/A ACCT #: 280-4082 PART K. Water Main Reimbursement Fee: N/A 110-4554 PART L. Maps and/or Improvement Plans By Developers As Specified in Item #23 Page <: of 11 NOW, THEREFORE, IT IS HEREBY MUTUALLY AGREED by and between the parties hereto as follows, TO WIT: DEDICATION A. The DEVELOPERS offer to dedic~ite 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 encurribrances except those which the CITY shall waive in writing. The DEVELOPERS agree 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 AGREEMF;NT the DEVELOPERS agree to deliver a properly executed grant deed to the CITY ~~f the real property described in Exhibit "A", and such other executed conveyances, or i~istruments necessary to convey clear title as herein required. The DEVELOPERS shall- provide, at the DEVELOPERS' 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 su:m 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; said policy shall be furnished at the time of acceptance of dedication and recordation of deed. C. Upon the condition precedent that the DEVELOPERS 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 DEVELOPERS shall install ar,~d complete the Work within one (1) year from the date of execution of this AGREEMEN'T', or such longer period as may be specifically authorized in writing by the City Engineer. In the event the DEVELOPERS fail 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 whatever 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 DEVELOPERS or the DIVELOPERS' 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 ? of 11 B. The DEVELOPERS shall install acid complete the Work 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 heret~~. The decision of the City Engineer shall be final as to whether any material or workm~inship 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 of Public Works, California Department of Transportation, State of California, and in accordance with the specifications of the Cupertino Sanitary District where applicat~le. 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 Public 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 ov~:r and be used in lieu of such conflicting portions. 3. EXCAVATION PERMIT It is further agreed that the DEVELOPER~~ shall comply with Section Three of Ordinance No. 130 of the CITY by obtaining an exca~~ation 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 DEVELOPERS shall notify the City Engineer of the exact date and time when the proposed excavation is to commence. 4. QUITCLAIM DEED It is further agreed that the DEVELOPER~~, when requested by the CITY, shall quitclaim all his rights and interests in, and shall gra~it to CITY authorization to extract water from the underground strata lying beneath said I~roject and DEVELOPERS agree to execute a "Quitclaim Deed and Authorization" in favor of CITY, when presented to them for signature. Page ~G of 11 5. BONDS AND OTHER SECURITY A. Upon the execution of this AGREEMENT, the DEVELOPERS shall file with the CITY a faithful performance bond to assure 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 AGREEMENT, 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 tr~is AGREEMENT, the DEVELOPERS 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 of all labor and materials required to construct said improvements. The amount of said bends shall be as designated by the City Engineer. Said bonds shall be executed by a surety a~mpany 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 DEVELOPERS shall fail faithfully to perform the covenants and conditions oj.'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 o~:herwise indemnify the CITY for the DEVELOPERS' failure to so do. B. In lieu of a faithful performance surety bond, the DEVELOPERS may elect to secure this AGREEMENT by depositing vrith 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 instrument of credit meeting the requirements of Government Code Section 66499 (b) or (c). C. The amount of said cash, checks, a~rtificate 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 DEVELOPERS furnished the CITY with a faithful performance surety bond. In the event that the DEVEL~~PERS shall fail faithfully to perform the covenants and conditions of this AGREEIv1ENT, or to make any payment, or 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. 1. Schedule for bond and insurance release for paper bonds are as follows: A. Release of 90 percent of the faithful performance bond upon acceptance by City Council Page :i of 11 B. Release of the remaining 10 percent of the performance bond at one year from ;acceptance after all deficiencies have been corrected and in the absence of any claim against such bond. C. Release of the entire labor and material bond at six months from acceptance after z~ll 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 a;;ainst such insurance. 2. Schedule for Bond and Insi:rance Release for Cash, CD, Set-Aside Letter are as Follows: A. Release of 45% of bond upon acceptance by City Council. B. Release of additiona145% at six months from acceptance after all deficiencies have been corrected and in the absence of any claim against such bona. 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 liability insurance, provided by the developers or contractor to hold the City 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 b~: paid on any security deposited with the CITY. 6. CHECKING AND INSPECTION FEE It is further agreed that DEVELOPERS shill pay any and all necessary direct expenses for inspection, checking, etc., incurred by CITY in connection with said Project, and that DEVELOPERS shall have deposited with CITY, prior to execution of this AGREEMENT, the amount as set forth herein at Page 2 (Pert C.). Should construction cost vary materially from the estimate from which said sum is calculated, the City Engineer shall notify DEVELOPERS of any additional sum due and owing as a result thereof. Page ti of 11 7. INDIRECT EXPENSES It is further agreed that DEVELOPERS shall pay to CITY, prior to execution of this AGREEMENT, indirect expense allocable to processing these improvements, the amount as set forth herein at Page 2 (Part D). MAP CHECKING FEE It is further agreed that the DEVELOPER S shall 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 ~ 1 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 deposit 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 o f the surety bonds or other security permitted under paragraph S.B by the CITY. Should the DEVELOPERS complete the required repairs to the entire satisfaction of the CITY, the unused balance will be returned after the release of the surety bond or other security permitted under paragraph S.B. 10. STORM DRAINAGE FEE It is further agreed that the DEVELOPERS shall 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 establisr~ed in Resolution 4422, March 21, 1977, in the amount as set forth herein at Page 2 (Part I~ ). 11. WATER MAIN EXTENSION DEPOSIT The DEVELOPERS 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. Page '~ of 11 12. ONE YEAR POWER COST It is further agreed that the DEVELOPERS 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 DEVELOPERS shall, at such time as deemed appropriate by the City Engineer, plant street trees in conformance 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 fixrther stipulated under Part J, Page 2 herein.Fees are also in accordance with action adopted by the City Council on March 19, 1991 and Chapter 14.05 or Section 18-1.602 of the Cupertino Municipal Code. 15. MAINTENANCE OF WORK It is further agreed that the DEVELOPERS 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 DEVELOPERS shall, Lipon 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 imperfection: 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~~ shall file with CITY, upon execution of this AGREEMENT, a letter from the Cupertino Sanitary District stating that the DEVELOPERS have 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 the provisions as set forth in Paragraph 15 above has been filed. Page f. of 11 17. GOVERNMENT CODE It is further agreed that DEVELOPERS 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, pert~iining to special assessments or bonds, have been complied with. 18. CENTRAL FIRE DISTRICT It is further agreed that the DEVELOPERS shall file with the CITY, upon execution of this AGREEMENT, a letter from the Central Fire Protection District of Santa Clara County, stating that the DEVELOPERS Have entered into an AGREEMENT with said District to install fire hydrants to serve s~iid 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 DEVELOPERS shall pay to Pacific Gas and Electric Company and/or to PACIFIC BELL Company any and all fees required for installation of overhead and/or underground wiring circuits to all electroliers within said property and any and all fees required for undergrounding as provided in Ordinance No. 331 of CITY when are notified by either the City Engineer or the Pacific Gas and Electric Company and/or Pacific Bell Company that said fe~:s 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 DEVELOPERS 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 DEVELOPERS 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 fetes 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 the performance of the Work by the DEVELOPERS or his contractor and continuing until the completion of the maintenance of the Work, the DEVELOPERS shall ind~;mnify, hold harmless and defend the CITY Page !~ of 11 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 DEVELOPERS or the DEVELOPERS' 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. 22. INSURANCE It is further agreed that: The DEVELOPE:E~S shall take out, or shall require any contractor engaged to perform the work to take out, and 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. Said 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 of said DEVELOPERS. Both bodily injury and property damage insurance must be on an ~~ccurrence 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 ii.'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 b~ 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 eac}i 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 DEVELOPERS shall file with the City Engineer at or prior to the time of execution of this AGREEMENT by the DEVELOPERS 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 endorsemer-t 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 i~isured 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 Page 10 of 11 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 to municipality and political subdivision. 23. MAPS AND/OR IMPROVEMENT PLAITS It is further agreed that the CITY shall obt;~in the following map and/or plans at the DEVELOPERS' 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 DEVELOPERS agree to pay the CIT~~ 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 DEVELOPERS. The as:~ignment of this AGREEMENT shall not be made without approval by the City Council of the City of Cupertino. IN WITNESS WHEREOF, CITY has cau~;ed its name to be hereunto affixed by its Mayor and City Clerk, thereunto duly authorized by res~~lution of the City Council and said DEVELOPERS have hereunto caused their nam~;s to be affixed the day and year first above written. Approved as to form: ~' ~ ~ ~ ~G City A' CITY OF CUPERTINO: May Notary Acknowledgment Required Exhibit A Attached Page 11 of 11 1V1alKa Nagel ALL PURPOSE ACKNOWLEDGMENT STATE OF CA OR A ~ ~ ~} COUNTY OF - On ~"~"~ °~l ~~' ~ ,before me, ~ ~'~-~L®' V ~ °~~'~~~'~-~-~`~ (~ - personally personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are sub:;cribed to the within instrument and acknowledged 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 Ripon behalf of which the person(s) acted, executed the Instrument. WITNE,~,~ my hand and offic~l seal. ~ / ~ r ~ ~, Signature ~ ~I%C~ ~ ,... TARA J. DENHAM rr-n ~~- : Comm, # 1158933 --nn iJ! `s ~~~* NOTARY PUBLIC-~1,L'IFORNIA U~ ~ ~ Santa Clara County `~ My Comm, Expires Nov, 14, 2001 "~` (This area for official notarial seal) ATTENTION NOTARY: Although the information requesteii below is OPTIONAL, it could prevent fraudulent attachment of this certificate to another document. THIS CERTIFICATE MUST BE ATTACHED TO THE DOCUMENT DESCRIBED AT RIGHT. Title of Document Type ~~.~2e2,l~2E%~~ Numl;er of Pages 1 ~-- Date of Document ~~ ~- U Signer(s) Other Than Named Above