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18-146 Installation Agreement, 22823 San Juan Rd Cupertino CA 95014, APN 342-22-078RECORDING REQUESTED BY: City of Cupe1iino WHEN RECORDED , MAIL TO : City Clerk's Office City of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 NO FEE IN ACCORDANCE WITH GOV. CODE 27383 23995893 Regina Alcomendras Santa Clara County -Clerk-Recorder 08/02/2018 12:33 PM Ti t.les: 1 Fees : 10 .00 Taxes : 0 Total: 0.00 Pages: 15 (SPACE ABOVE THIS LINE FOR RECORDER'S USE) INSTALLATION AGREEMENT 22823 San Juan Road, Cupertino CA 95014 APN: 342-22-078 Original D For Fast Endorsement NO FEE" City of Cupertino CERTIFICATE OF ACCEPTANCE is hereby given in order to comply with the provisions of Section 27283 of the Government Code. This is to certify that the interest in real property conveyed by the deed or grant dated June 29, 2018, from 22823 San Juan Road, Cupertino, CA 95014 to the City of Cupertino, a governmental agency, is hereby accepted by order of the Public Works Director, and the grantee consents to recordation thereof by its duly authorized officer. Dated: July 27, 2018 By: Senior Office Assistant City of Cupertino INSTALLATION AGREEMENT (Cupertino Municipal Code Chapter 14.04) 22823 San Juan Road, Cupertino, CA APN: 342-22-078 This INST~L~TION AGREEMENT {"Agreement") for street improvements is made and entered into this 1_ ( day of ---J t0U,_# , 2018, by and between the CITY OF CUPERTINO, a municipal corporation of the State of California, {"CITY"), and Amy Cheng, a married woman as her sole and separate property {"DEVELOPER") for a new 2-story residence located at 22823 San Juan Road, Cupertino, CA {APN 342-22-078). RECITALS 1. DEVELOPER has presented to the City an application for a development entitlement consisting of a new 2-story residence (the "Development Entitlement") located at 22823 San Juan Road, Cupertino CA {the "Property"). 2. Chapter 14 .04 of the Cupertino Municipal Code {"CMC") requires, as a condition precedent to the erection, construction, addition, alteration or repair of any building or structure in certain designated areas of the City with unimproved streets and for which a building permit is required by the City, installation of certain types of public improvements and/or dedication where deemed necessary by the City Engineer. 3 . In consideration of City's approval of the Development Entitlement and pursuant to the requirements of CMC Chapter 14.04, Developer desires to enter into this Agreement promising to install and complete, at Developer's sole expense, all public improvement work required by the City for the proposed development. 4 . Developer has prepared and City has approved plans and related specifications {the "Improvement Plans") for construction, installation and completion of improvements. The Improvement Plans titled "Improvement Plans for Cheng Residence -22823 San Juan Road, Cupertino, CA", prepared by Green Civil Engineering, Inc . and dated March 28, 2018, are hereby incorporated into this Agreement by reference. NOW, THEREFORE, in consideration of the approval by City of the Development Entitlement, City and Developer agree as follows : Page I of 11 1. DEVELOPER'S OBLIGATION TO INSTALL IMPROVEMENTS a. Completion of Improvements. Developer, at its own expense, shall furnish, install, and construct all improvements required by the City Engineer pursuant to Chapter 14.04 of the Cupertino Municipal Code, or as amended, in a good and workmanlike manner and as shown on the Improvement Plans as approved by the City Engineer of Cupertino and in accordance with existing ordinances and resolutions of the CITY and other applicable laws. The decision of the City Engineer shall be final as to whether any material or workmanship meets the plans, specifications, and standards as set forth. b. Compliance with applicable laws and rules . Developer shall complete the Work 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 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 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 over and be used in lieu of such conflicting portions. Developer shall acquire all necessary permits, including an encroachment permit from the City of Cupertino Public Works Department, prior to beginning work in the public right of way. c. Repair and replacement of damaged public facilities. Developer shall, at its own expense, repair or replace all public improvements, public utility facilities, surveying monuments and other public facilities that are destroyed or damaged as a result of any work under this agreement. Developer shall promptly notify the City Engineer of such damage and shall obtain the City Engineer's approval of all repair and replacement of damaged facilities. d. Developer's responsibility until City's acceptance. Until City accepts the Improvements, Developer shall be responsible for the care and maintenance of such improvements and shall bear all risks of loss or damage to the improvements. City shall not have any liability for any accident, loss or damage to the Improvements prior to their completion and acceptance by City. City's acceptance of the Improvements shall not constitute a waiver of any defects in the Improvements or Developer's obligation to repair such defects as provided in section 9 of this Agreement. 2. TIME FOR INSTALLATION OF IMPROVEMENTS a. Required time of completion. DEVELOPER shall install and complete the Improvements 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 whatever manner the CITY shall decide. In the event the CITY completes the Work, the CITY may recover any and all costs incurred Page 2 of 11 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. 3. DEDICATION OF EASEMENTS OR RIGHTS OF WAY No dedication required. 4. QUITCLAIM DEED DEVELOPER, when requested by the CITY, shall quitclaim all his/her rights and interests in, and shall grant to CITY authorization to extract water from the underground strata lying beneath said project. DEVELOPER agrees to execute a "Quitclaim Deed and Authorization" in favor of CITY, when presented to him/her for signature. 5. SECURITY a. Required Security. Prior to execution of this Agreement, Developer shall provide the following security to City in a form acceptable to the City: (1) Faithful performance. Security for faithful performance in the amount set forth Part A of Exhibit A, the SCHEDULE OF BONDS, FEES AND DEPOSITS. (2) Labor and Materials. Security for labor and materials in the amount set forth Part B of Exhibit A, the SCHEDULE OF BONDS, FEES AND DEPOSITS. b. Form of Security. Developer shall provide as security, bonds executed by a surety company authorized to transact a surety business in the State of California and approved by the City as to sufficiency. In the event that the DEVELOPER shall fail to faithfully 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 do so . In lieu of a surety bond, the DEVELOPER may elect to secure this AGREEMENT by depositing with the CITY (1) Cash; (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 acceptable to the City and meeting the requirements of Government Code Section 66499 (b) or (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 faithful performance surety bond. In the event that the DEVELOPER shall fail to faithfully 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 may apply the proceeds of said security thereto. Page 3 of 11 c. Release of Security. No release of surety bond, cash deposit, check or certificate of deposit shall be made except upon approval of the Director of Public Works. Schedule for bond and insurance release for paper bonds a re as follows: (1} Release of 90 percent of the faithful performance bond upon acceptance by the Director of Public Works. (2} 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. (3} 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 . (4} 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. 6. PAYMENT OF REQUIRED FEES a. Permits and licenses. Developer shall, at its sole expense, obtain all necessary permits and licenses for the construction and installation of the Improvements, give all necessary notices, and pay all fees required by City ordinance, including but not limited to the fees described in this Agreement, and all taxes required by law. b. Fees. Developer shall pay fees in the amounts set forth in Exhibit A, including but not limited to the following, as required: (1} Inspection Fees. DEVELOPER shall pay any and all necessary direct expenses for inspection, checking, etc. incurred by CITY in connection with said Project, and that DEVELOPER shall have deposited with CITY all such amounts prior to execution of this AGREEMENT. Should construction cost vary materially from the estimate from which said sum is calculated, the City Engineer shall notify DEVELOPER of any additional sum due and owing as a result thereof. (2} Storm Drainage Fee. DEVELOPER 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 established in Resolution 4422, March 21, 1977. (3} Map Checking Fee. DEVELOPER 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 . (4} Park Fee. DEVELOPER shall pay such fees and/or dedicate such land to the CITY, prior to execution of this AGREEMENT, as is required within Section 18-1.602, Park Land Dedication, Cupertino Municipal Code. Park fees are calculated 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. Page 4 of 11 7. STREET TREE INSTALLATION DEVELOPER shall fund the City for purchase and planting of street trees as deemed appropriate by the City Engineer; or sha II, at the discretion and at such time as deemed appropriate by the City Engineer, plant street trees in conformance with the standards of the City of Cupertino. The variety, number and location of trees are subject to City's prior approval. 8. MAINTENANCE AND WARRANTY a. Developer guarantees and warrants the Improvements and agrees to remedy any defects, damages, or imperfections in the Improvements arising from faulty or defective materials or construction of the Improvements for a period of one year after City's acceptance of the Improvements. b. If, within the warranty period, the Improvements or any part of the Improvements fail to fulfill any of the requirements of this Agreement or the Improvement plans and specifications, Developer shall repair, replace or reconstruct any defective or otherwise unsatisfactory parts of the Improvements without delay and at no cost to City . If (a) Developer fails to commence repairs within thirty (30) days of the date of mailed written notice from City, or (b) City determines that public safety requires repair before Developer can be notified, City may, at its sole option, perform the required repair itself. Developer agrees to pay the cost of any repairs City performs pursuant to this agreement and City may, at its option, recover that cost as a lien against Developer's property. 9. SANITARY DISTRICT DEVELOPER shall file with the CITY, upon execution of this AGREEMENT, a letter from the Cupertino Sanitary District stating that the DEVELOPER has submitted plans for review by the District and that sanitary sewers are available to serve all lots within said Project. 10. GOVERNMENT COSTS DEVELOPER shall file with the 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. 11. UTILITIES DEVELOPER shall pay to Pacific Gas and Electric Company, AT&T, and/or appropriate utility companies, 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 the DEVELOPER is notified by either the City Engineer, Pacific Gas and Electric Company, AT&T, or appropriate utility companies that said fees are due and payable. Page 5 of 11 12. EASEMENTS AND RIGHT-OF-WAY Developer shall acquire any easement and right-of-way necessary for completion of the Project at its own cost and expense . However, that in the event eminent domain proceedings are required, the CITY for the purpose of securing said easement and right-of-way, 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. 13. HOLD HARMLESS AND INDEMNIFICATION To the fullest extent allowed by law, DEVELOPER shall indemnify and hold harmless CITY, its City Council, boards and commissions, officers, officials, agents, employees, servants, consultants and volunteers (hereinafter, "lndemnitees") 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, arising out of or in any way related to Developer's performance or nonperformance of his/her duties under this Agreement, or from negligent acts or omissions or willful misconduct of Developer, its agents, employees, contractors, or subcontractors. Developer shall, at his/her own cost and expense, defend any and all claims, actions, suits or legal proceedings that may be brought against the City or any of the lndemnitees (with council acceptable to City) in connection with this Agreement or arising out of Developer's performance or nonperformance of his/her duties and obligations hereunder, 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. 14. INSURANCE Prior to commencing any of the Public Improvements or Work referenced in this Agreement, DEVELOPER shall procure and maintain for the duration of the contract, insurance against claims for injuries to persons or damages to property which may arise from or in connection with the performance of the work hereunder by Developer, its contractor, agents, representatives, employees or subcontractors. Coverage shall be at least as broad as: 1. Commercial General Liability (CGL): Insurance Services Office (ISO) Form CG 00 01 covering CGL on an "occurrence" basis, written on a comprehensive general liability form, and must include coverage for liability arising from Developer's Contractors acts or omissions, including Contractor's protected coverage, blanket contractual, products and completed operations, vehicle coverage and employer's non-ownership liability coverage , with limits of at least $2,000,000 per occurrence . The CGL policy must protect against any and all liability for personal injury, death, property Page 6 of 11 damage or destruction, and personal and advertising injury. If a general aggregate li mit applies, either the general aggregate limit shall apply separately to this project/location (ISO CG 25 03 or 25 04) or the general aggregate limit shall be twice the required occurrence limit. a. Any available insurance proceeds broader than or in excess of the specified minimum insurance coverage requirements and/or limits shall be made available to the Additional Insured and shall be (1) the minimum coverage/limits specified in this agreement; or (2) the broader coverage and maximum limits of coverage of any insurance policy, whichever is greater. b. Additional Insured coverage under Developer's policy shall be "primary and non- contributory" and shall be at least as broad as ISO CG 20 01 04 13. c. The limits of insurance required may be satisfied by a combination of primary and umbrella or excess insurance, provided each policy complies with the requirements set forth in this Contract. Any umbrella or excess insurance shall contain or be endorsed to contain a provision that such coverage shall also apply on a primary and non-contributory basis for the benefit of City before the City's own insurance or self-insurance shall be called upon to protect City as a named insured . 2. Automobile Liability covering owned, hired, and non-owned autos, with limit no less than $1,000,000 per accident for bodily injury and property damage . 3. Workers' Compensation: As required by the State of California, with Statutory Limits, and Employer's Liability Insurance of no less than $1,000,000 per accident for bodily injury or disease . If Developer maintains broader coverage and/or higher insurance limits, City will be entitled to Developer's broader coverage and/or higher limits. The City of Cupertino, its City Council, officers, officials, employees, agents, servants and volunteers are to be covered as additional insureds on the CGL policy. Endorsement of CGL coverage shall be at least as broad as ISO Form CG 20 10 11 85 or if not available, through the addition of both CG 20 10, CG 20 26, CG 20 33, or CG 20 38; and CG 20 37 if a later edition is used. For any claims related to this Agreement or the Work, Developer's insurance shall be "primary and non-contributory'' and at least as broad as ISO CG 20 01 04 13 with respect to City, its officers, officials, employees and volunteers, and shall not seek contribution from City's insurance. If the limits of insurance are satisfied in part by Umbrella/Excess Insurance, the Umbrella/Excess Insurance shall contain or be endorsed to contain a provision that such coverage shall also apply on a "primary and non-contributory" basis for the benefit of City . Each insurance policy must provide that coverage will not be canceled, except with 30 days' notice to City. Each certificate of insurance must state that the coverage afforded by the policy is in force and will not be reduced, cancelled or allowed to expire without at least 30 days advance written notice to City, unless due to non-payment of premiums, in which case ten days advance written notice must be provided to City. Such notice must be sent to City via certified mail and addressed to the attention of the City Manager. Page 7 of 11 Each required policy must include an endorsement providing that the carrier agrees to waive any right of subrogation it may have against City. Further, Developer agrees to waive any rights of subrogation which any of Developer's insurers may acquire from Developer by virtue of payment of any loss . Developer agrees to obtain any endorsement that may be necessary to affect this waiver of subrogation . The Workers' Compensation policy must be endorsed with a waiver of subrogation in favor of the City for all work performed by Developer or Developer's Contractor, its employees, agents and subcontractors. · Insurance must be issued by insurers licensed in the State of California and with an A.M. Best's financial strength rating of "A VII" or better. 15. MAPS AND/OR IMPROVEMENT PLANS Developer shall provide CITY with the following maps and/or plans at the DEVELOPER'S expense : A. A mylar blackline of fully executed parcel map. B. A scan in raster format of all executed improvement plans and map . 16. SUCCESSORS AND ASSIGNS-COVENANT RUNNING WITH THE LAND This Agreement shall inure to the benefit of, and be binding upon the heirs, administrators, successors, assigns and transferees of the Parties, and shall be recorded in the Office of the County Recorder and constitute a covenant running with the land. Upon any sale or division of the Property, the terms, covenants, conditions and restrictions of this agreement shall apply to each parcel, and the owner or owners of each parcel shall succeed to the obligations imposed upon developer by this Agreement. 17. FAILURE TO PERFORM In the event developer fails to perform one or more of the covenants and conditions of this agreement, City at its option shall have recourse to the security given to guarantee the performance of such acts . City may, at its option, do or cause to be done, the acts required of Developer and shall have recourse against as much of the security is necessary to discharge Developer's responsibility. City shall also have recourse against developer for any and all amounts necessary to complete the obligations of developer in the event that the security is insufficient to pay such amounts. All administrative costs, including reasonable attorney's fees incurred by City in addition to the costs of the improvements shall be proper charges against the security and Developer. 18. NOTICES All notices, demands, requests or approvals to be given under this Agreement shall be given in writing and conclusively shall be deemed served when delivered personally or on the second Page 8 of 11 business day after the deposit thereof in the United States Mail, postage prepaid, registered or certified, addressed as hereinafter provided. All notices, demands, requests, or approvals from Developer to City shall be addressed to City at : City of Cupertino 10300 Torre Ave . Cupertino CA 95014 Attention: Public Works Director All notices, demands, requests, or approvals from City to Developer shall be addressed to Developer at: Amy Cheng P.O. Box 298 Oakland, CA 94604 19. GOVERNING LAW AND ATTORNEY FEES This Agreement shall be interpreted under, and enforced by the laws of the State of California excepting any choice of law rules which may direct the application of laws of another jurisdiction. The Agreement and obligations of the parties are subject to all valid laws, orders, rules, and regulations of the authorities having jurisdiction over this Agreement (or the successors of those authorities.) Any suits brought pursuant to this Agreement shall be filed with the courts of the County of Santa Clara, State of California. If City sues to compel Developer's performance of this Agreement, or to recover damages or costs incurred in completing or maintaining the work on the Improvements, Developer agrees to pay all attorney's fees and other costs and expenses of litigating incurred by the City, even if Developer subsequently resumes and completes the work. 20. RELATIONSHIP OF PARTIES Neither Developer nor any of its contractors, employees or agents shall be deemed to be agents of the City in connection with the Performance of Developer's obligations under this agreement. 21. SEVERABILITY The provisions of this Agreement are severable. If any portion of this Agreement is held invalid by a court of competent jurisdiction, the remainder of the agreement shall remain in full force and effect. 22. INTEGRATED AGREEMENT This Agreement represents the full and complete understanding of every kind or nature whatsoever between the parties hereto, and all. preliminary negotiations and agreements of Page 9 of 11 whatsoever kind or nature a r e merged herein. No verbal agreement or implied covenant shall be held to vary the provisions hereof. Any modification of this Agreement will be effective only by written execution signed by both City and Developer. All unchecked boxes do not apply to this Agreement. IN WITNESS WHEREOF, the Parties have caused this agreement to be executed by their respective, duly authorized officers on the date listed above. CITY OF CUPERTINO: ~====--Timm Borden, P.E . Director of Public Works DEVELOPER : ,., Attach Notary acknowledgement Exhibits : Exhibit A -Schedule of Bonds, Fees and Deposits Page IO of 11 Exhibit A SCHEDULE OF BONDS, FEES, AND DEPOSITS Street Improvement Category: PART A . PART B. PART C. PART D. PART E. PART F. PART G. 280-4082 PART H . PART I. PART J . Faithful Performance Bond: Labor and Material Bond : Checking and Inspection Fee: (includes 4th Plan Check Review Fee , $165 .00) Storm Drainage Fee : Street Light -One-Year Power Cost: Map Checking Fee : Park Fee: Grading Permit Fee : Grading Bond: 3rd Party Geotechnical Initial Review Fee: Page 11 of 11 $61,000.00 $61,000.00 $3 ,514.00 $1,306 .00 $0.00 $0.00 $63,000 .00 $3,720 .00 $62,000.00 $3,450.00 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT A norary pubLic or other officer completing this ce~tificate verifies only the identity of the individual who signed the document t0 which this certificate is' attached, and not the truthfulness, accuracy , or vaLidiry of that document. State of California County of Santa Clara On.;2 2 c,0,.... ~/.fbefore,.. me , Kirti Patel , Notary Public, personally appeared --A'f1 v C.l{tf='N 4 . who pro\'ed to k on the basis of satisfactory evidence to be the person"81 whose name,"81 is/jre subscribed to the within instrument and acknowledged to me that pl/she/th)-1 executed the same in ~/her/t],'ir authorized d.pacity(j?'), and that by Jr!her/thy!r signatureµ) on the instrument the person_yf), or the encity upon behalf of which the person~ acted, executed the instrument. 1 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 SEALr ::~"0000 ~~;;1;:;;: 0 ****f ~ ~j!( ' ~,; NOTARY PUBLIC -CALIFORNIA ~ " ~ COMMISSION# 2178864 E? ~ c. .,. ' SANTA CLARA COUNTY - ;. '-s.li ,, My Comm . Exp . January 27, 2021 ).~'"\>if+~·•ti• Signature of Notary PubLic (Notary Seal) t , OPTIONAL INFORMATION The atknowledgment tontained within this docMment is in affordan1e with California law. A,ry ttrlijicate of acknowledgement performed within the State of California shall use /he preceding wording pursuant to Civil Code section 17 89. An acknowledg- ment cannot be affixed to a document sent by mail or otherwise deh'vered to a notary pubh'c, including electronic means, whereby the signer did not personally appear before the notary pubh'c, even if the signer is known by the notary pubh'c. In addition, the correct notarial wording can only be signed and sealed by a notary pubh'c. The seal and signature can.not be af.ixed ro a document without the correct notan'aJ wording. DESCRIPTION OF ATTACHED DOCUMENT (Title of document) Number of Page s / / (lncluding acknowledgment) Document Date --~te ... ' ~,. ... /_ef_~~ ... ~~~':k)=~ .. ~L~tf--~--- / MMXV H .WARDALE 92.S .786 .890!) -.ToullyNoury.ntt CAPACITY CLAIMED BY SIGNER ___ ,__-_ lndividual Corporate Officer Partner Attorney-In-Fact r Tru-stee Other: 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 6 oA C/y.) ... (,._ } On -J ~ lct-/Ol t before me, U .. LIA ~ personally appeared ·n tf\J, ... l(l/-- who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that 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 instrument. I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. NotaryP~re (Title or description of attached docu MN ~~d>-M · (Title or description of attached document continued) Number of Pages Jl Document Date l n /J1{l b CAPACITY CLAIMED BY THE SIGNER ·ti:J Individual (s) D Corporate Officer (Title) D Partner(s) D Attorney-in-Fact o Trustee(s) 0 Other _________ _ 201 5 Version www.N otary Classes.com 8 00-873-986 5 (Notary Public Seal) INSTRUCTIONS FOR COMPLETING THIS FORM This form complies with current California statutes regarding notary wording and, if needed, should be completed and attached lo the do cument. Acknowledgments fi'om other states may be completed for documents being sent to that state so long as the wording does not require the California notary to violate Ca lifornia nota,y lmv. • 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 fo llowed 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 singu lar or plural forms by cross ing off incorrect forms (i.e . Re/s he/1!,ey,-is /are) or circling the correct forms . Failure to correc tl y indicate this information may lead to rejection of document recording . • The notary sea l impression must be clear and photographically reproducible. lmpression must not cover te xt or lines . If seal impression smudges, re-seal if a sufficient area permits, otherwise comp lete a different acknowledgment form . • Signature of the notary public must match the signature on file with the office of the county c lerk. •:• Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. •:• Indi cate title or type of attached document, number of pages and date . •:• In dicate th e capacity claimed by the signer. If the c laimed capacity is a corporate officer, indicate the title (i.e . CEO, CFO, Secretary). • Securely attach this document to the signed document with a staple.