18-224 Subdivision Agreement, 22561 Alcalde Rd APN 342-29-063RECORDING 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 IN ACCORDANCE
WITH GOV. CODE 27383
24074654
Regina Alcomendras
Santa Clara County -Clerk-Recorder
12/03/2018 03:44 PM
Ti lies: 1
Fees : 10.00 Taxes: 0
Total: 0.00
Pages: 22
(SPACE ABOVE THIS LINE FOR RECORDER'S USE)
SUBDIVISION AGREEMENT
22561 Alcalde Road, Cupertino, CA
APN 342-29-063
· ' Original
D For Fast Endorsement
UNO FEE"
City of Cupertino
CERTIFICATE OF ACCEPTANCE is hereby given in order to comply with the
provisions of Section 27383 of the Government Code.
This is to certify that the interest in real property conveyed by the deed or grant
dated August 28, 2018, from
22561 Alcalde Road, Cupertino, CA
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:
By:
November 27, 2018
auren Sapudar
Senior Office Assistant
City of Cupertino
SUBDIVISION AGREEMENT
22561 Alcalde Road, Cupertino, CA 95014
APN : 342-29-063
This AGREEMENT ("Agreement") is made and entered into this ~ day of ~~. ,
2018 , by and between the CITY OF CUPERTINO , a municipal corporation of the State of Caliornia, ("CITY"),
and Cynthia Group, LLC, a California Limited Liability Company and Greenleaf Group, LLC, a California
Limited Liability Company, each as to an undivided 50% interest as tenants in common, ("Subdivider") for a
two lot subdivision located at 22561 Alcalde Road , Cupertino, CA .
RECITALS
1. Pursuant to the Subdivision Map Act of the State of California and the City's local ordinances and
regulations relating to subdivision maps, Subdivider has presented to the City for approval a parcel map
titled "Parcel Map -Being a subdivision of the lands as described in that certain grant deed which was
recorded on January 23 , 2017, as Document No. 23563964, in Santa Clara County Official Records, and lying
entirely within the City of Cupertino, Santa Clara County, CA" (the "Map") for the subdivision of certain real
property in the City of Cupe rtino, designated as Parcel Map for two lot subdivision at 22561 Alcalde Road
(the "Subdivision").
2. Subdivider has prepared and City has approved the following plans and related specifications
(the "Improvement Plans") for construction, installation and completion of certain public improvements in
connection with the Subdivision (the "Improvements). The Improvement Plans are on file in the City's
Department of Public Works and are incorporated into this Agreement by this reference .
3. Subdivider, has also offered for dedication to City certain streets, ways and easements
delineated on the Map (the "Dedications").
4. On (')cf, }) , 2018, the Director of Public Works approved the Map and offers of
dedication shown on the Map, conditioned on Subdivider entering into this Agreement to construct and
complete the Improvements.
NOW, THEREFORE, in consideration of City's approval of · the Map, and in order to insure
satisfactory performance by Subdivider of its obligations under the Subdivision Map Act and the Cupertino
Municipal Code, City and Subdivider agree as follows:
1. SUBDIVIDER'S OBLIGATION TO CONSTRUCT IMPROVEMENTS
a. Completion of Improvements. Subdivider, at its own expense , and in compliance with all provisions
of the Subdivision Map Act , the Cupertino Municipal Code , the Map and any amendments thereto, and
other applicable laws, shall furnish, install, and construct all required improvements in conformance with
the Improvement Plans. 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. Subdivider shall construct the Improvements and the
improvements shall be constructed in accordance with the most current Standard Specifications of the
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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.
c. Repair and replacement of damaged public facilities. Subdivider 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. Subdivider 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. Subdivider's responsibility until City's acceptance. Until City accepts the Improvements, Subdivider
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 Subdivider's obligation to repair such
defects as provided in section 9 of this Agreement.
e. Time for installation of improvements. SUBDIVIDER 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 pursuant to section l(f) of this Agreement (time
extensions). In the event the SUBDIVIDER 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 all costs incurred thereby
from the SUBDIVIDER or the SUBDIVIDER'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.
f. Time extensions . The City Engineer, in his or her sole discretion, may approve, in writing, a request for
extension or completion of the time required for construction of the Improvements upon a showing of
good cause by the Subdivider. Good cause may include delay resulting from an act of the City, acts of God,
strikes, boycotts, or similar job actions which prevent the conduct of the work. In approving a request for
time extension, the City Engineer may impose reasonable related conditions, such as requiring Subdivider
to furnish new or modified improvement security guaranteeing performance of this Agreement, as
extended, in an increased amount necessary to compensate for any projected increase in the estimated
total cost of Improvements, as determined by the City Engineer.
g. Permits. Subdivider shall, at its own expense, obtain and comply with the conditions of all necessary
permits and licenses for the construction of the Improvements and give all necessary notices and pay all
fees and taxes required by law.
2. ACQUISITION AND DEDICATION OF EASEMENTS OR RIGHTS OF WAY
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a. SUBDIVIDER offers to dedicate the real property shown on the Map as filed for record with the
County of Santa Clara, which is made a part hereof by reference (the "Dedicated Property"). Upon the
condition precedent that the SUBDIVIDER shall perform each and every covenant and condition of this
AGREEMENT, the CITY agrees to accept said real property offered for dedication .
The Dedicated Property shall be free and clear of all liens or encumbrances except those which the CITY
agrees to waive in writing. Subdivider agrees not to revoke this offer of dedication, and to keep said offer
open until the CITY accepts offer. Upon execution of this Agreement, Subdivider agrees to deliver a
properly executed grant deed to the CITY of the real property described in the Map, and such other
executed conveyances, or instruments necessary to convey clear title as herein required . The SUBDIVIDER
shall provide, at the SUBDIVIDER 'S sole cost and expense, to the City at the time of acceptance of
dedication and recordation of deed, (1) a preliminary title report issued by a title insurance company
relating to the property offered for dedication, and (2) a standard policy of title insurance issued by a title
insurance company and insuring the CITY, showing that the Dedicated Property is free and clear of all liens
or encumbrances except any that the City expressly agreed to waive.
b. Subdivider 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, SUBDIVIDER 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.
3. INSPECTION AND FINAL ACCEPTANCE
a. Subdivider shall at all times maintain proper facilities and safe access for inspection of the
Improvements by the City Engineer.
b. Upon completion of the improvements or any category of improvements in compliance with the
Improvement Plans and all applicable City standards, then the City Engineer shall certify completion of the
Improvements. Subdivider shall bear all costs of inspection and certification for acceptance. Acceptance by
the City Engineer shall not constitute a waiver by the City of any defects in the Improvements.
4. QUITCLAIM DEED
SUBDIVIDER, 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. SUBDIVIDER
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, Subdivider 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 in Part A of
Exhibit A, the SCHEDULE OF BONDS , FEES AND DEPOSITS , attached and incorporated by reference
as Exhibit B.
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(2) Labor and Materials. Security for labor and materials in the amount set forth in Part B of Exhibit
A, the SCHEDULE OF BONDS, FEES AND DEPOSITS, attached and incorporated by reference as
Exhibit C.
b. Form of Security. Subdivider 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 SUBDIVIDER 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
SUBDIVIDER'S failure to do so.
In lieu of a surety bond, the SUBDIVIDER 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 (a) or (b). 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 SUBDIVIDER furnished the CITY with a faithful performance surety bond.
In the event that the SUBDIVIDER 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.
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 are 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, reduced to
an amount equal to the total amount claimed by all claimants for whom liens have been filed
and of which notice has been given to the City, plus an amount reasonably determined by the
City Engineer to be required to assure the performance of any other obligations secured by the
security. The balance of the security shall be released upon settlement or release of all claims
and obligations for which the security was given.
(4) Liability insurance, provided by the SUBDIVIDER 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 the insurance.
6. PAYMENT OF REQUIRED FEES
a. Permits and licenses . Subdivider shall, at its sole expense, obtain all necessary permits and licenses
for the construction and instal lati6n 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.
Page 4 of 14
b. Fees. Subdivide r shall pay fees in the amounts set forth in Exhibit A, including but not limited to the
following, as required :
(1) Inspection Fees . SUBDIVIDER shall pay all necessary direct expenses for inspection, checking,
etc . incurred by CITY in connection with said Project, and that SUBDIVIDER shall have deposited
sufficient funds with CITY, prior to execution of this AGREEMENT . Should construction costs
vary materially from the estimate from which this sum is calculated , the City Engineer shall
notify SUBDIVIDER of any additional sum due and owing as a result thereof.
(2) Storm Drainage Fee. SUBDIVIDER 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. SUBDIVIDER 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. SUBDIVIDER shall pay such fees and/or dedicate such land to the CITY, prio r 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 orig i nally adopted
by the City Counc i l on March 19, 1991 and Chapter 14.05 or Section 18-1.602 of the Cupertino
Municipal Code and as subsequently amended.
(5) Reimbursement Fee . SUBDIVIDER shall deposit with the CITY , prior to execution of this
AGREEMENT, a reimbursement fee for any street improvements that have been installed by the
City, or by another property owner. Subdivider shall pay the City for the cost of the land at the
cost to the City , or another property owner, and shall pay a street improvement
reimbursement charge for the improvements which the City or another property owner,
installed on the street abutting or included in the benefited property, in an amount equal to the
total improvement costs for each particular benefited property as set forth in a reimbursement
agreement . Payments for both land and improvements shall include simple interest in the
amount of seven percent per year, to be calculated in the following manner:
(i) Land Cost. Interest to accrue from the date the street improvements are accepted by
the City to the date the street improvements reimbursement charge is paid , or if the land is
purchased by the City for a City project, from the date of purchase to the date the charge is
paid.
(ii) Improvement Cost . Interest to accrue from the date the street improvements are
accepted by the City to the date the street improvement reimbursement charge is paid , or
if installed by the City, from the date installation commenced to the date the charge is paid.
(iii) Provided, however, that the interest shall be waived if the adjoining property owner
dedicates or has dedicated to the City land necessary for the street improvements, or
where no such dedication is necessary.
7 . DEVELOPMENT MAINTENANCE DEPOSIT
SUBDIVIDER shall pay to the CITY, prior to execution of this AGREEMENT, the amount set forth in Exhibit A
as a development maintenance deposit. City may use the deposit at its discretion to correct deficiencies
and conditions caused by the SUBDIVIDER or his/her contractor that may arise during or after the
construction of the development, and to obtain copies of approved plans for the CITY 's files . If the costs
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exceed the amount deposited, SUBDIVIDER shall pay actual overage prior to return of original plans. Any
unexpended amount will be returned to the SUBDIVIDER at the time all bonds are released in accordance
with paragraph 5 of this agreement.
8. STREET TREE INSTALLATION
SUBDIVIDER shall provide funds to the City for purchase and planting of street trees as deemed appropriate
by the City Engineer; or shall , 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.
9. MAINTENANCE AND WARRANTY
a. Warranty Period. Subdivider guarantees and warrants the Improvements and agrees to remedy
any defects, damages, or imperfections in the Improvements ar ising from faulty or defective materials or
construction of the Improvements for a period of one (1) year after City's final acceptance of the
Improvements. Subdivider's obligation under this section shall include the repair, replacement, or
reconstruction of all irrigation systems and all trees, shrubs, ground cover and landscaping for the required
one-year period .
b. Warranty repairs and replacements . 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, Subdivider shall repair, replace or reconstruct any defective or otherwise unsatisfactory
parts of the Improvements without delay and at no cost to City . If (a) Subdivider 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 Subdivider can be notified, City may, at its sole option, perform the required
repair itself. Subdivider agrees to pay the cost of any repairs City performs pursuant to this agreement and
City may, at its sole option, recover that cost as a lien against Subdivider's property .
10. SANITARY DISTRICT
SUBDIVIDER shall file with the CITY, upon execution of this AGREEMENT, a letter from the Cupertino
Sanitary District stating that the SUBDIVIDER has submitted plans for review by the District and that
sanitary sewers are available to serve all lots within the Project.
11. GOVERNMENT COSTS
SUBDIVIDER shall file with the CITY , upon execution of this AGREEMENT , substantial evidence that all
provisions of Section 66493 , A rt icle 8, Chapter 4 of the Government Code, pertaining to special assessments
or bonds, have been complied with .
12. UTILITIES
SUBDIVIDER shall pay to Pacific Gas and Electric Company, AT&T, and/or appropriate utility companies, all
fees required for installation of overhead and/or underground wiring circuits to all electroliers within said
property and all fees required for undergrounding as provided in Ordinance No . 331 or subsequently
adopted ordinances of CITY or regulations of the appropriate utilities when the SUBDIVIDER is notified by
P age 6 of 14
either the City Engineer, Pacific Gas and Electric Company, AT&T, or appropriate utility companies that said
fees are due and payable.
13. HOLD HARMLESS AND INDEMNIFICATION
a. To the fullest extent allowed by law, Subdivider 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 Subdivider's performance or nonperformance of his/her
duties under this Agreement, or from negligent acts or omissions or willful misconduct of
Subdivider, its agents, employees, contractors, or subcontractors. Subdivider 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 Subdivider's performance or nonperformance of his/her
duties and obligations hereunder, including all claims, demands, causes of action, liability or loss
because of or arising out of, in whole or in part, the design and construction of the improvements.
This indemnification and agreement to hold harmless shall extend to injuries to persons and
damages or taking of property resulting from the design or construction of the Subdivision, and
the public improvements described in this Agreement, and in addition, to adjacent property
owners as a consequence of the diversion of waters from the design or construction of public
drainage systems, streets and other public improvements, 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.
b. Acceptance by City of the Improvements shall not constitute an assumption by City of any
responsibility for any damage covered by this section. City shall not be responsible for the design or
construction of the subdivision or the improvements pursuant to the approved Improvement Plans or map,
regardless of any negligent action or inaction taken by the City in approving the plans or map, unless the
particular improvement design was specifically required by City over written objection by Subdivider,
indicating that the particular improvement design was dangerous or defective and suggested an alternative
safe and feasible design, submitted to the City Engineer before approval of the particular improvement
design .
c. After City's acceptance of the Improvements, Subdivider shall remain obligated to correct or
eliminate any defect in design or dangerous condition created by defects in design or construction,
provided however, that developer shall not be responsible for routine maintenance . Provisions of this
section shall remain in full force and effect for ten (10) years following City's acceptance of the
Improvements. Subdivider acknowledges and agrees that Subdivider shall be responsible and liable for the
design and construction of the Improvements and other work done pursuant to this Agreement and that
City shall not be liable for any acts or omissions in approving, reviewing, checking, correcting, or modifying
any Improvement Plans or related specifications or in approving, reviewing or inspecting any work or
construction. The improvement security shall not be required to cover the provisions of this paragraph
beyond the guarantee and warranty period specified in this agreement .
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14. INSURANCE
Prior to commencing any of the Public Improvements or Work referenced in this Agreement,
SUBDIVIDER 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 SUBDIVIDER, its contractor, agents, representatives,
.employees or subcont r actors.
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 SUBDIVIDER '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 al/ liability for personal injury, death,
property damage or destruction, and personal and advertising injury. If a general aggregate limit
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 SUBDIVIDER's policy shall be "prima r y and non-
contributory" and shall be at I.east 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 SUBDIVIDER maintains broader coverage and/or higher insurance limits, City will be entitled to
SUBDIVIDER's broader coverage and/or higher limits.
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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, SUBDIVIDER'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.
Each required policy must include an endorsement providing that the carrier agrees to waive any
right of subrogation it may have against City. Further, SUBDIVIDER agrees to waive any rights of
subrogation which any of SUBDIVIDER 's insurers may acquire from SUBDIVIDER by virtue of payment
of any loss. SUBDIVIDER 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 SUBDIVIDER or SUBDIVIDER'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
Subdivider shall provide CITY with the following maps and/or plans at the SUBDIVIDER'S expense:
A. A mylar blackline and three (3) prints of fully executed parcel map .
B. A mylar blackline and three (3) prints of fully executed improvement plans.
C. A scan in raster format of all executed improvement plans and map.
D. One (1) Yz size prints of fully executed plans and map.
The SUBDIVIDER agrees to pay the CITY from the development maintenance deposit the cost for all prints
of plans and maps . If costs exceed the amount deposited the SUBDIVIDER is required to pay actual overage
prior to return of original plans.
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16. ASSIGNMENT
Subdivider shall not assign this agreement without the prior written consent of the City. Any attempted or
purported assignment in violation of this paragraph shall be null and void and have no force or effect. The
sale or other disposition of the Project shall not relieve Subdivider of its obligations under this agreement. If
subdivider intends to sell the Project or any portion of the Project to any other person or entity,
Subdivider may request a novation of this Agreement and substitution of improvement security .
17. 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 Subdivider by this Agreement.
18. DEFAULT, BREACH, AND REMEDIES TO CITY
a. Default. Default of Subdivider shall include, but not be limited to:
(1) Subdivider's failure to timely commence construction of Public Improvements under
this Agreement;
(2) Subdivider's failure to timely complete construction of the Improvements;
(3) Subdivider's failure to timely cure any defect in the Improvements;
(4) Subdivider's failure to perform substantial construction work for a period of 20
consecutive calendar days after commencement of the work;
(5) Subdivider's insolvency, appointment of a receiver, or the filing of any petition in
bankruptcy, either voluntary or involuntary, which Subdivider fails to discharge within 30
days;
(6) The commencement of a foreclosure action against the subdivision or a portion thereof,
or any conveyance in lieu or in avoidance of foreclosure; or
(7) Subdivider's failure to perform any other obligation under this Agreement.
b. City reserves all remedies available to it at law or in equity for breach of Subdivider's obligations
under this Agreement. The City shall have the right, subject to this section, to draw upon or use the
appropriate security to mitigate City's damages in the event of default by Subdivider. City's right to draw
upon or use the security is in addition to any other remedy available to City. The parties acknowledge that
the estimated costs and security amounts may not reflect the actual cost of construction of the
improvements and, therefore, City's damages for Subdivider's default shall be measured by the cost of
completing the required improvements. City may use the sums provided by the security for completion of
the Improvements in accordance with the Improvement Plans .
c. In the event that Subdivider fails to cure any default under this Agreement within twenty (20)
days after the City mails written notice of such default to Subdivider and Subdivider's surety, Subdivider
authorizes City to perform the obligations for which Subdivider is in default and agrees to pay the entire
cost of such performance by City.
Page 10 of 14
d. City may take over the work and complete the Improvements by contract or by any other
method the City deems appropriate, at the expense of Subdivider, and Subdivide r's surety shall be liable to
City for any excess cost or damages to City resulting therefrom . In such event, City, without liability for so
doing, may take possession of and use any of Subdivide r's materials, appliances, plant and other property
that are at the work site and are necessary to complete the Public Improvements.
e. Subdivider's failure to comply with the terms of this Agreement constitutes Subdivider's consent
for the City to file a notice of violation against all lots in the Subdivision or to rescind or otherwise revert
the subdivision to acreage. Subdivider specifically recognizes that the determination of whether a reversion
to acreage or recission of the subdivision approval constitutes an adequate remedy for Subdivider's default
shall be within City's sole discretion. The remedy provided by this Subsection is in addition to all other
remedies available to City, and Subdivider agrees that the choice of remedy or remedies for Subdivider's
breach shall be within City's discretion.
f. In the event that Subdivider fails to perform any obligation under this Agreement, Subdivider
agrees to pay all costs and expenses incurred by City in securing performance of those obligations, including
but not limited to fees and charges of architects, engineers, attorneys and other professionals, and costs of
suit and reasonably attorneys' fees.
g. City's failure to take enforcement action with respect to a default, or to declare a breach, shall
not be construed as a waiver of that default or breach or any subsequent default or breach by Subdivider.
19. SUBDIVIDER NOT AGENT OF CITY
Neither Subdivider nor any of Subdivider's agents or contractors are or shall be considered to be agents of
City in connection with the performance of Subdivider's obligations under this Agreement.
20. SUBDIVIDER TO WARN PUBLIC
Until final acceptance of the improvements, Subdivider shall give good and adequate warning to the public
of any dangerous condition of the Improvements, and shall take reasonable actions to protect the public
from such dangerous condition.
21. 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 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 Subdivider to City shall be addressed to City at:
City of Cupertino
10300 Torre Ave .
Cupertino CA 95014
Attention: Public Works Director/City Engineer
All notices, demands, requests, or approvals from City to Subdivider shall be addressed to Subdivider at:
Cindy Hsu, Manager
10229 Scenic Blvd.
Page 11 of 14
Cupertino , CA 95014
22. NO VESTING OF RIGHTS
Performance by Subdivider of this Agreement shall not be construed to vest Subdivider's rights with respect
to any change in any zoning or building law or ordinance .
23. TIME IS OF THE ESSENCE
Time is of the essence in the performance of this agreement by subdivider.
24. NONDISCRIMINATION
Subdivider, its agents, employees, contractors and subcontractors shall not discriminate in any way against
any person on the basis of age, sex, race, color, religion, sexual orientation, actual or perceived gender
identity, disability, ethnicity, or national origin in connection with or related to the performance of this
Agreement.
25. GOVERNING LAW AND ATIORNEY 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 Subdivider's performance of this Agreement, or to recover damages or costs incurred
in completing or maintaining the work on the Improvements, Subdivider agrees to pay all attorneys' fees
and other costs and expenses of litigating incurred by the City, even if Subdivider subsequently resumes
and completes the work.
26. RELATIONSHIP OF PARTIES
Neither Subdivider nor any of its contractors, employees or agents shall be deemed to be agents of the City
in connection with the Performance of Subdivider's obligations under th is agreement.
27. 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.
28. 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 whatsoever kind or nature
are 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
Subdivider. All unchecked boxes do not apply to this Agreement.
Page 12 of 14
IN WITNESS WHEREOF , the Parties have caused this agreement to be executed by their respective, duly
authorized officers on the date listed above .
~ocioF-.~
Acting City Attorney
Attach Notary acknowledgement for Subdivide r's signatures:
Attachments:
Exhibit "A"-Schedule ofBonds, Fees, Deposits
Exhibit "B" -Faithful Performance Bonds
Exhibit "C"-Labor and Materials Bonds
Page 13 of l4
CITY OF CUPERTINO :
~ .... '. ___ _
Director of Public Works
SUBDIVIDER :
Cynthia Group, LLC
Greenleaf Group, LLC
~d~~ Cindy ~anager
Street Improvement Category:
PART A.
PART B.
PART C.
PART D.
PART E.
PART F.
PART G.
PART H.
PART I.
Exhibit A
SCHEDULE OF BONDS, FEES , AND DEPOSITS
Faithful Performance Bond:
$110,000.00
Labor and Material Bond:
$110,000.00
Checking and Inspection Fee :
$3,798.00
Development Maintenance Deposit:
$0.00
Storm Drainage Fee
$2,001.00
Traffic Impact Fee
$6,177
Map Checking Fee:
$5,527 .90.00 (PAID)
Park Fee
$84,000.00
Street Tree Fee
$796.00
Page 14 of 14
cm
CUPE~INO
Annual Premium$ 2 ,200.00
Bond Number : 4 1399219
FAITHFUL PERFORMANCE AND CO!vfPLETION IMPROVEMENT BOND
KNOW ALL MEN BY THESE PRESENTS:
That we, Greenleaf Group. LLC and Cynthia Group. LLC
as Principal and Platte River Insurance Company
as Surety are held and firmly bound unto the City of Cupertino, State of California, in
One Hundred Ten Thousand and 00/100 Dollars ($110,000 .00
the sum of
) we bind
ourselves, our heirs, executors, successors, and assigns, jointly and severally, firmly by these presents .
THE CONDITION of the foregoing obligation is such that, .. · ;,
WHEREAS , said Principal will perform all necessary improvements relative to
a two lot subdivision
located 22561 Alcade Rd Cupertino CA 95014 in accordance with the approved improvement
plans prepared by ...CR-'-'o"--'b"-'eC..Crt-'--'-W-'--'a=n-'-g"--------------' Civil Engineer on file in the Engineer's
Office, City of Cupertino, and incorporated herein by reference .
WHEREAS, improvements shall be completed within one (1) year from the date of acceptance of this bond
by the City Council.
WHEREAS, improvements shall be maintained for a period of at least one (1) year after acceptance of
construction by the City. This bond shall be in full force and effect through the period of maintenance as provided in
said contract. The maintenance period shall continue until such time that all deficiencies of construction are corrected
to the satisfaction of the City Engineer's Office.
WHEREAS, Principal and Surety shall be responsible for any and all damages arising under the original
contract.
NOW THEREFORE, if the said Principal shall well and truly do and perform all the covenants and
obligations as set forth above, on its part to be done and performed at the time and in the manner specified therein,
then this obligation shall be null and void, otherwise, this bond shall remain in full force and effect.
In witness whereof, this instrument has been duly executed by the Principal and Surety this 20 day of
August , 20.11;L_. Greenleaf Group , LLC and Cynthia Group , LLC
(To be signed by Principal and Sure_ty .
Notary Acknowledgements required.) Principal
The above bond is accepted and approved this ____ day of ______ , 20 __ .
2/4/00
--
PLA.TTE RIVER INSURANCE COMPANY
POWER OF ATTORNEY
413992 1 9
KNOW ALL MEN BY THESE PR ESENTS. That the PLATTE RI VE R INSU RANCE COMPANY , a corpo rat io n o f th e State of Nebraska. ha v in g
it s principal offices in the City of M idd leton. Wi scons in, does make. constitute and appo int
CHRIS ELEY ; AMELIA MCSHAN E; JASON JENK.lNS ------------------
it s tru e a nd la wful Attorney(s)-in-fart. to make .execute. seal and delive r for and on its behalf, as surety. a nd as it s act a nd deed. any a nd a ll bond s. unde rtakings
and c ontracts of suret ys hip . pro v ided that no bond or und ertak in g o r contract of s ure tys hip executed under thi s a uthority shall exceed in amount th e sum of
-------------------------------------ALL WRITTEN rNSTRUMENTS fN AN AMOUNT NOT TO EXCEED : $20 ,0 00,000 .00 --------------------------------
This Power of Attorn e y is granted and is signed and sea led by facs imile under and by th e a utho rity of the following Resoluti on adopted b y th e Board of
Di rectors of PLATTE RIVER INSU RA NCE COM PA NY at a mee ting duly called a nd he ld o n th e 8th day of January. 2002.
'·RESOLVE D, that the Pre side nt . Executive Vice Pres ident. Vice Pres id e nt . Secretary o r Treasure r . acting indi vid ua ll y o r o th e r w ise . be and th ey he reby
are granted the power a nd a uth orization to a ppo int by a Power of A tt o rn ey fo r th e p urpo ses o nl y of executin g a nd att estin g bo nd s a nd un dertak in gs. and
othe r writ in g s obli ga to ry in the na tu re th e reof. one or more res ident vice-pres ide nts , ass istant sec re tari es a nd art orney(s)-in -fac t, eac h appoimee to ha ve
th e powers a nd du1ies usual to s u c h o ffi ces to 1h e bu sin ess o f thi s com pany; th e sig nature o f suc h office rs and sea l o f th e Com pany may be affixed to any
such powe r ol' attorn ey o r to any ce rtificate relat ing there to by facs imile. a nd any s uch power of attorney or ce rti fica te bearing such facs imil e s ignatures
or facs imi le sea l sh all be va lid and b in ding u pon the Co mpa ny. and any suc h power so exec ut ed an d certified by facsi mil e s igna tures a nd fac s imil e sea l
sha ll be va lid a nd binding u pon the Comp a ny in th e fu ture with respec t to any bond o r undertak in g o r other w ritin g o b liga tory in the nature thereof to
wh ic h it is attac hed . An y such a ppo int ment ma y be re voked. for m use. or w ithout cause , b y a ny of sa id officers, at any tim e."
In connectio n wi th ob li ga ti on s in fa vo r of the F lorida Department of Transpo nati o n only, it is ag reed th a t th e powe r and authority he reby g i ve n to th e
Attorney-in-Fac t includes a ny a mJ a ll co nsents for the re lease of re tained percem ages a nd/or final e stimates o n e n g in eerin g a nd co nstruc ti on cont racts
req u ired by th e State of Fl o r ida Department of T ransport ation. ft is full y unde r stood th a t conse ntin g to the State o f Fl o ri da De partment of Trans portation
mak ing payment of the final est imate to th e Contracto r and /or it s ass ignee. shall no t rel ieve thi s surety compa ny of a n y of it s ob li ga ti o ns unde r it s bo n d.
In conn ectio n with ob li gati o ns i n favo r of the K e ntucky D epartment of Hi g h ways o nl y. it is agreed that th e power a nd a utho rit y he reby given to the
Attorn ey-i n-Fac t cann o t be mod ified o r revoked unl ess prior writte n perso nal n oti ce of suc h inte nt has bee n g i ve n to th e Co mmi ssio ne r -Departme nt of
Hi g h ways o f th e Commonwea lth o f Ke ntu cky at lea st thi 11 y (3 0) days prio r to th e m odifi cati o n or re vocati o n .
IN WITNESS WHEREOf . the PLATTE RIV E R INSURANCE COMPANY ha s cause d th ese presents to be s ig ne d by it s officer un de rs igned a nd it s
~'.:"~ ht~::t <Im lru day of May. 2017
J~n E. R zepmskt
V ice Preside nt . T reasu rer & CFO
S uza nn e M . Bro ad be nt
A ss istant Secre tary
STATE OF WI SCONS IN }
COUNT Y OF DANE S .S ..
PLATTE RIVER IN SURANCE COMPANY
Ste ph e n J . Sill s
CEO & President
On th e 3rd day o f May , 2017 before me personal ly ca me Stephe n J. Si ll s . to me known , wh o being b y me du ly sworn , did d e po se a nd say: that he res id es
in the County of New York. Sta te of New Yo rk ; that he is Presi dent of PLATTE RIVER INS URANCE COMPANY . th e corporatio n descr ibed in a nd
which exec ut ed th e above inst ru ment; th at he knows the seal of the said corporat ion; th a t the seal affixed to said in strume nt is suc h corporate seal; that it
was so affixed by order of the Board o f Directors of said corporati o n a nd th at he s i gned hi s na me there to by like o rder. ·
STATE OF WISCONS IN
COUNTY OF DANE } S .S .
David J . Rege le
Notary Public. Dan e Co., Wl
M y Commi ss ion l s Permanen t
I. th e un ders igned. d ul y e lec ted to 1hc office stated bel ow, n ow th e in c um b e nt in PLATTE RIVER INSURANCE COMPANY . a Neb raska
Co r poration . a uth o ri zed to make this cert i fica le . DO HEREBY CERT IFY that the fo rego in g a ttac he d Powe r of Atto rn ey rema in s in fu ll fo rce and ha s.
no t bee n revoked: and furthermore. that the Reso lut ion of th e Board or Directors, se t fo rth in the Power of A llo rn ey is now in force.
Signed a nd sealed at th e City of Midd le to n. State of Wi sco ns in this--~-'-----day of ~ t\:'-r , 20 \.2:$'.
~~t~':\.--e SEAL ,i ~ i ~
Antonio Cel ii
Ge ne ral Coun se l. Vice Pre sid e nt & Seccre ta ry
THI S DOCU ME NT IS NOT VA LID UNLESS PR INTED ON GREEN S HADED BA CKGRO UN D WI TH A RED SE RI AL NU MBER IN THE UPP ER RIGHT HA ND
CO RNER . IF YOU HAVE Ai\Y QUES TI ONS CONCE RNING TH E AUTH EN TI CITY OF Tl-ll S DOC L:MEN T CALL 800 -4 75--1.\50.
.IL ·~
CITY OF
Bond Number : 413992 19
CUPEr{JINO
LABOR AND MATERIAL BOND FOR SUBDIVISION IMPROVEMENTS
Recitals
1. The City of Cupertino, California, and Green lea f Group LLC and Cynthia Group. LLC
(hereinafter referred to as "Principal", have entered into an agreement whereby Principal agrees to
install and complete certain designated public improvements, dated August 20 , 20j_§_, and
identified as project/tract no. ~:2~~9.0 5 3 is incorporated by tlus reference as if set forth in full; and,
2. Pursuant to the agreement, Principal is required, before commencing performance of the
work, to file a good and sufficient payment bond with the City of Cupertino to secure any claims
brought under Title 15, Division 3, Part 4 of the Civil Code ( commencing with Section 3082).
NOW THEREFORE, the Principal and the undersigned as corporate surety (hereinafter
referred to as "Surety") their heirs, successors, assigns, executors and administrators, jointly and
severally are held bound unto the City of Cupertino and all contractors, subcontractors, laborers,
materialmen and other persons employed in the performance of the agreement and referred in the
aforementioned Civil Code in the sum of One Hundred Ten Thousand and 00/100
dollars ($110,000 .00 ), for materials furnished or labor thereon of any kind, or for amounts due under
the Unemployment Insurance Act with respect to such work or labor, that the surety will pay the same
in an amount not exceeding the amount hereinabove set forth, and also in case suit is brought upon this
bond, will pay, in addition to the face amount thereof, costs and reasonable expenses and fees,
including reasonable attorney's fees, incurred by the City of Cupertino in successfully enforcing such
obligation, to be awarded and fixed by the court, and to be taxed as costs and to be included in the
judgement therein rendered.
It is hereby expressly stipulated and agreed that this bond shall inure to the benefit of any and
all persons, companies and corporations entitled to file claims under Title 15 ( commencing with
Section 3082) of Part 4 of Division 3 of the Civil Code, so as to give a right of action to them or their
assigns in any suit brought upon this bond.
Should the condition of this bond be fully performed, then this obligation shall become null and
void, otherwise, it shall be and remain in full force and effect.
The surety hereby stipulated and agrees that no change, extension of time, alteration or addition
to the terms of said agreement or the specifications accompanying the same shall, in any manner, affect
its obligations on this bond, and it does hereby waive notice of any such change, extension, alteration
or addition.
2/4/00
IN WITNESS WHEREOF, this instrum ent has been duly executed by the Principal and Surety
this 20 day of August , 20.J..L_.
(To be signed by Principal and Surety.
Notary Acknowledgements required .)
APPROVED AS TO FORM:
Greenleaf Group , LLC and Cynthia Group , LLC
Principal
By: ---------------
Platte River Insurance Company
Surety _
?t_5·( By·//~ ~ Chris Eley Attorney -io-Eacr b . d
The above bond is hereby accepted and approved this ___ day of ______ , 20 __ .
CITY OF CUPERTINO
By: ______________ _
2/4/00
CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT
A notary public o r other officer completing this certificate verifies only the ide ntity of the individual who signed the d ocument to
which this ce rtificate is a ttac h ed , a nd not the truthfulness, a ccuracy, or validity of th a t document.
State of California
County o&,,....,b___,.,'.'.l ~{r'l--"'-'-< __ CTru-c_'_--'--"-a,_,___
personally appeared ___ (-=--f' /_' ~J/l~c;{~b------+fu:--'--'-,____....l 1.,__ ___________________ _
\
who proved to me on th e basis of satisfactory evidence to be the person(s-rwhose name(-s) is /afe subscribed to
the within instrument and acknowledged to me that kefshe/tb:ey executed the same in hjs.Lher/tl;l.e.ir authorized
capacity(i.es), and that by his/her/theif-signature~)-on the instrument the person(s:};or the entity upon behalf of
which the person(s}·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
GRACE SCHMIDT
WITNESS my hand and of 1cial seal.
(Notary Seal)
Commission # 2098030
~ . ·• Notary Public -Callfornla I
z Santa Clara County ?: J. • • • 4 ,Ml ~OT"} [X~res reg t1,J~1;~
ADDITIONAL OPTIONAL INFORMATION
DESCRIPTION OF THE A TT ACHED DOCUMENT
(Titl e or description o f attached doc ume nt continu ed)
Number of Pages __ Document Dated ~ 2/;:
43 7 (/
(Additional infonnat ion)
CAPACITY CLAIMED BY THE SIGNER
D Individual (s)
D Corporate Officer
(Tit le)
0 Partner(s)
0 Attorney-in-Fact
D Truste e(s)
D Other ____________ _
INSTRUCTIONS FOR COMPLETING THIS FORM
Any acknowledgment co mpleted in Californ ia must co nt ain ve rbiage exactly as
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properly completed and atta ched to that document . Th e only exception is if a
docum e nt is to be recorded outs ide of Ca liforn ia. !n such instances , any alte rn ative
acknowledgment verb iage as may be printed on such a do cument so long as the
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C 2004-20 15 ProLink Sign in g Service, In c. -AJI Righ ts Reserved www.TheProLi nk.com -Na tionwide No ta ry Service
CALIFORNIA ALL-PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only t he 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 c;()../1/\.,to__ Wwc., }
On ~J 3 Jl)1 J
personally appeared 7l if\A--LM__
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 an9 official seal.
(Notary Public Seal)
INSTRUCTIONS FOR COMPLETING THIS FORM
ADDITIONAL OPTIONAL INFORMATION This form complies with current Ca lifornia statutes regarding notary wording and,
DESCRIPTION OF THE A TT A~ED DOCUMENT J . if needed. should be completed and attached to the document. Acknowledgments
L,, L bJ... , V \ S l , 'VJ ....r from other states may be completed for documents being sent to that state so long h ~ , [\,l ~ , · I ,l ff as the wording does not require the California notary to violate California nota,y
c,:, _51o l C U4c 0 e::: law.
(Title or description of attached doc ument) • State and County informati on must be the State and County where the document (\,p N =3 4 · J-~'fl,.. O (o3 signer(s) personally appeared befo re the notary public for acknowledgment.
(Title or description of attached document conti nued } .
Number of Pages _1.1_ Document Date 1i I U { l J
C<)PACITY CLAIMED BY THE SIGNER
It!\ Individual (s)
D Corporate Officer
(Title)
D Partner(s)
D Attorney-in-Fact
o Trustee(s)
0 Other _________ _
2015 Version www.NotaryClasses .com 800-873-9865
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•!• Indi cate title or type of attached document, number of pages and date .
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