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21-276 Encroachment Agreement, GTE Mobilenet dba Verison Wireless, 18660 Newsom Ave, Cupertino CA 95014This Encroachment Agreement (“Encroachment Agreement”), made as of the last date signed below (“Effective Date”) between the City of Cupertino, a political subdivision of the State of California, hereinafter designated “Licensor” and GTE Mobilnet of California Limited Partnership, d/b/a Verizon Wireless, with its principal offices at c/o Verizon Wireless, 180 Washington Valley Road, Bedminster, New Jersey 07921, hereinafter designated “Licensee”: 1.Encroachment Agreement. This is an Encroachment Agreement as referenced in that certain Small Cell License Agreement between Licensor and Licensee dated May 16, 2017 ("Agreement"). This Encroachment Agreement shall serve as an encroachment license. All of the terms and conditions of the Agreement are incorporated hereby by reference and made a part hereof without the necessity of repeating or attaching the Agreement. In the event of a contradiction, modification or inconsistency between the terms of the Agreement and this Encroachment Agreement, the terms of the Encroachment Agreement shall govern. Capitalized terms used in this Encroachment Agreement shall have the same meaning described for them in the Agreement unless otherwise indicated herein. 2.Project Description and Locations. Licensee shall have the right to use the ROW for a Small Cell at the designated areas in the ROW as further described in Attachment 1 attached hereto (the “Licensed Area”). 3. Equipment. The Small Cell to be installed at the Licensed Area is described in Attachment 1 attached hereto. 4.Term. The term of this Encroachment Agreement shall be as set forth in Section 2 of the Agreement. 5.Fees. The initial annual Rent for the term of this Encroachment Agreement shall be Three Hundred Dollars ($300) and paid in accordance with Paragraph 5.1 of the Agreement, as amended by Section 4, to that certain Settlement Agreement and Mutual Release entered into between Licensor and Licensee dated October 4, 2017, and as adjusted by Paragraph 5.2 of the Agreement. 6.Commencement Date. The first day of the month following the date Licensee has Commenced Installation of its Equipment at the Licensed Area. 7. Approvals/Fiber. It is understood and agreed that Licensee's ability to use the Licensed Area is contingent upon its obtaining all of the certificates, permits and other approvals (collectively the "Governmental Approvals") that may be required by any Federal, State or Local authorities, as well as a satisfactory fiber and electrical connection which will permit Licensee use of the Licensed Area as set forth above. In the event that (i) any of such applications for such Governmental Approvals should be finally rejected; (ii) any Governmental Approval issued to Licensee is canceled, expires, lapses, or is otherwise withdrawn or terminated by governmental authority; (iii) Licensee determines that such Governmental Approvals may not be obtained in a CA_SJ_CUPERTINO 313 18660 Newsom Avenue, Cupertino CA 95014 ENCROACHMENT AGREEMENT 545443DocuSign Envelope ID: FBF853B9-7C15-45A0-9521-09B9E65FD6F1DocuSign Envelope ID: 1865B63E-5505-4C24-9788-492799D18006 timely manner; (iv) Licensee determines that it will be unable to obtain in a satisfactory manner, or maintain any fiber or power connection; or (v) Licensee determines that the Licensed Area is no longer technically compatible for its use, Licensee shall have the right to terminate this Encroachment Agreement. Notice of Licensee's exercise of its right to terminate shall be given to Licensee in writing by certified mail, return receipt requested, and shall be effective upon the mailing of such notice by Licensee, or upon such later date as designated by Licensee. All rentals paid to said termination date shall be retained by Licensor. Upon such termination, this Encroachment Agreement shall be of no further force or effect except to the extent of the representations, warranties and indemnities made by each party to the other hereunder. Otherwise, Licensee shall have no further obligations for the payment of Rent to Licensor. 8.Miscellaneous. N/A [Signature page follows] DocuSign Envelope ID: FBF853B9-7C15-45A0-9521-09B9E65FD6F1DocuSign Envelope ID: 1865B63E-5505-4C24-9788-492799D18006 EXECUTED to be effective as of the last date shown below. LICENSOR: City of Cupertino, a political subdivision of the State of California By: ___________________________ Name: _________________________ Title: __________________________ Date: ___________________________ ATTEST: Date: ___________________________ APPROVED AS TO FORM CITY ATTORNEY’S OFFICE BY: __________________________ Print Name: _____________________ Date: __________________________ City Attorney LICENSEE: GTE MOBILNET OF CALIFORNIA LIMITED PARTNERSHIP, D/B/A VERIZON WIRELESS by Cellco Partnership, its General Partner By: Date: ______________________________ Name: Alba Barber Title: Senior Real Estate Manager Exhibits: Attachment 1 , Clerk DocuSign Envelope ID: FBF853B9-7C15-45A0-9521-09B9E65FD6F1DocuSign Envelope ID: 1865B63E-5505-4C24-9788-492799D18006 Dec 16, 2021 Dec 16, 2021 Christopher D. Jensen City Engineer Dec 17, 2021 Chad Mosley Dec 17, 2021 Attachment 1 Licensed Area See attached. DocuSign Envelope ID: FBF853B9-7C15-45A0-9521-09B9E65FD6F1DocuSign Envelope ID: 1865B63E-5505-4C24-9788-492799D18006 T-1 TITLE SHEET DRAWN BY: CHECKED BY:BPM APE IT IS A VIOLATION OF THE LAW FOR ANY PERSON, UNLESS THEY ARE ACTING UNDER THE DIRECTION OF A LICENSED PROFESSIONAL ENGINEER, TO ALTER THIS DOCUMENT 0 08/13/21 100% CD REV DATE DESCRIPTION MODUS, LLC 240 STOCKTON ST., 3RD FLOOR SAN FRANCISCO, CA 94108 APPROVED BY:LJB CA_SJ_CUPERTINO_313 VERIZON WIRELESS 2785 MITCHELL DRIVE, SUITE 9 WALNUT CREEK, CA 94598 (NEAR) 18660 NEWSOM AVE CUPERTINO, CA 95014 1 08/25/21 100% CD 2 09/15/21 100% CD PLAN CHECK SITE INFORMATION SITE ADDRESS: OWNER: APPLICANT: LATITUDE: LONGITUDE: COUNTY: ASSESSORS PARCEL NUMBER: ZONING: ELEVATION: CITY OF CUPERTINO 10300 TORRE AVE CUPERTINO, CA 95014 VERIZON WIRELESS 2785 MITCHELL DRIVE, SUITE 9 WALNUT CREEK, CA 94598 37° 18' 35.770" N NAD83 121° 59' 53.880" W NAD83 SANTA CLARA PUBLIC RIGHT OF WAY NEAR 375-30-001 CITY OF CUPERTINO 210.1' AMSL VICINITY MAPPROPOSED POLE PHOTO N DRAWING INDEX T-1 SHEET NO. TITLE SHEET T-2 GENERAL NOTES A-1 SITE PLAN & ENLARGED SITE PLAN A-2 A-4 ELEVATIONS CIRCUIT DIAGRAM D-1 DETAILS CODE COMPLIANCE ALL WORK AND MATERIALS SHALL BE PERFORMED AND INSTALLED IN ACCORDANCE WITH THE CURRENT EDITIONS OF THE FOLLOWING CODES AS ADOPTED BY THE LOCAL GOVERNING AUTHORITIES. NOTHING IN THESE PLANS IS TO BE CONSTRUCTED TO PERMIT WORK NOT CONFORMING TO THESE CODES. ·2019 CALIFORNIA CODE ·2019 CALIFORNIA BUILDING CODE (CBC), BASED ON THE 2018 IBC ·2019 CALIFORNIA RESIDENTIAL CODE (CRC), BASED ON THE 2018 IRC ·2019 CALIFORNIA ELECTRICAL CODE (CEC), BASED ON THE 2017 NEC ·2019 CALIFORNIA MECHANICAL CODE (CMC), BASED ON THE 2018 UMC ·2019 CALIFORNIA PLUMBING CODE (CPC), BASED ON THE 2018 UPC ·2019 CALIFORNIA GREEN BUILDINGS STANDARDS CODE (CALGREEN) ·2019 CALIFORNIA FIRE CODES WITH ALL LOCAL AMENDMENTS ·ANY LOCAL BUILDING CODE AMENDMENTS TO THE ABOVE ·CITY / COUNTY ORDINANCES SHEET TITLE E-1 ELECTRICAL GENERAL NOTES E-2 ONE-LINE DIAGRAM & GROUNDING SCHEMATIC E-3 ELECTRICAL DETAILS ACCESSIBILITY REQUIREMENTS FOR PERSONS WITH DISABILITIES: FACILITY IS UNMANNED AND NOT FOR HUMAN HABITATION. ACCESSIBILITY IS NOT REQUIRED IN ACCORDANCE WITH CALIFORNIA ADMINISTRATIVE STATE CODE PART 2, TITLE 24, CHAPTER 11B, SECTION 1103B. SURVEY PROJECT TEAM PROJECT DESCRIPTION D-2 DETAILS THE UTILITIES SHOWN HEREIN ARE FOR THE CONTRACTORS CONVENIENCE ONLY. THERE MAY BE OTHER UTILITIES NOT SHOWN ON THESE PLANS. THE ENGINEER/SURVEYOR ASSUMES NO RESPONSIBILITY FOR THE LOCATIONS SHOWN AND IT SHALL BE THE CONTRACTOR'S RESPONSIBILITY TO VERIFY ALL THE UTILITIES WITHIN THE LIMITS OF THE WORK. ALL DAMAGE MADE TO THE (E) UTILITIES BY THE CONTRACTOR SHALL BE THE SOLE RESPONSIBILITY OF THE CONTRACTOR. CALL 811 BEFORE YOU DIG IT'S THE LAW MODUS PROJECT MANAGER: MODUS, LLC 240 STOCKTON ST., 3RD FLOOR SAN FRANCISCO, CA 94108 PHONE: (415) 989.1102 EMAIL: VERIZONPOLYGONTEAM@MODUS-CORP.COM CONSTRUCTION/IMPLEMENTATION MANAGER: MODUS, LLC 240 STOCKTON ST., 3RD FLOOR SAN FRANCISCO, CA 94108 PHONE: (415) 989.1102 EMAIL: VERIZONPOLYGONTEAM@MODUS-CORP.COM A&E PROJECT MANAGER: MODUS, LLC 240 STOCKTON ST., 3RD FLOOR SAN FRANCISCO, CA 94108 PHONE: (415) 989.1102 EMAIL: VERIZONPOLYGONTEAM@MODUS-CORP.COM APPLICANT: VERIZON WIRELESS 2785 MITCHELL DRIVE, SUITE 9 WALNUT CREEK, CA 94598 CONTACT: CHRIS MOLLER PHONE: (925) 339.2778 EMAIL: CHRIS.MOLLER@VERIZONWIRELESS.COM LAND USE PLANNER: MODUS, LLC 240 STOCKTON ST., 3RD FLOOR SAN FRANCISCO, CA 94108 PHONE: (415) 989.1102 EMAIL: VERIZONPOLYGONTEAM@MODUS-CORP.COM SITE ACQUISITION: MODUS, LLC 240 STOCKTON ST., 3RD FLOOR SAN FRANCISCO, CA 94108 PHONE: (415) 989.1102 EMAIL: VERIZONPOLYGONTEAM@MODUS-CORP.COM SITE C-1 A-3 ELEVATIONS VERIZON WIRELESS PROPOSES TO INSTALL A NEW WIRELESS COMMUNICATION SITE ON A LIGHT POLE IN THE PUBLIC RIGHT-OF-WAY. SCOPE: ·INSTALL (2) 5G ANTENNA/RADIOS INSIDE NEW FRP CONCEALMENT SHROUD ON TOP OF POLE ·INSTALL (1) NEW DISCONNECT / SMART METER ON SIDE OF POLE ·INSTALL NEW POLE AND FOUNDATION TO REPLACE EXISTING ·TRENCHING FOR POWER PER SHEET A-1 D-3 POLE SPECS (NEAR) 18660 NEWSOM AVE CUPERTINO, CA 95014 (NEAR) 18660 NEWSOM AVE CUPERTINO, CA 95014 CA_SJ_CUPERTINO_313 SITE ID: SITE TYPE: POLE #: COUNTY: PSLC: CX PROJECT ID: CA_SJ_CUPERTINO_313 LIGHT POLE TBD SANTA CLARA 545443 20191962708 D-4 CITY STANDARD DETAILS Maintain 15ft clear in front of bench, see comments sht A1 DocuSign Envelope ID: FBF853B9-7C15-45A0-9521-09B9E65FD6F1DocuSign Envelope ID: 1865B63E-5505-4C24-9788-492799D18006 X X X X X X X X X X X X S/L X X X X X X X X X X X X S/L X X X X X X X X X X X X X X X X FIBER FIBER FI B E R S/L S/L S/L S/L S/L S/L X X X X S/L S/L S/L S/L S/L S/L S/L S/L DRAWN BY: CHECKED BY:BPM APE IT IS A VIOLATION OF THE LAW FOR ANY PERSON, UNLESS THEY ARE ACTING UNDER THE DIRECTION OF A LICENSED PROFESSIONAL ENGINEER, TO ALTER THIS DOCUMENT 0 08/13/21 100% CD REV DATE DESCRIPTION MODUS, LLC 240 STOCKTON ST., 3RD FLOOR SAN FRANCISCO, CA 94108 APPROVED BY:LJB CA_SJ_CUPERTINO_313 VERIZON WIRELESS 2785 MITCHELL DRIVE, SUITE 9 WALNUT CREEK, CA 94598 (NEAR) 18660 NEWSOM AVE CUPERTINO, CA 95014 1 08/25/21 100% CD 2 09/15/21 100% CD PLAN CHECK A-1 SITE PLAN 1ENLARGED SITE PLAN N SITE PLAN2 N 3 A-1 ENLARGED SITE PLAN 1&2 A-3 1&2 A-2 (E) CONCRE T E S I D E W A L K 1/16"=1'-0" SCALE 1/2"=1'-0" SCALE (N) LIGHT POLE & FOUNDATION (N) LOCATION OF VERIZON WIRELESS ANTENNA IN FRP SHROUD MOUNTED ON LIGHT POLE PROPERTY LI N E (E) CURB & GUTTER 2' - 1 1 " ± BA C K O F P O L E T O R O W L I N E (N) LOCATION OF VERIZON WIRELESS ANTENNA AND EQUIPMENT A.P.N.: 375-30-001 ELECTRICAL LINE STREET LIGHT LINE E S/L FIBER LINE(S)FIBER LEGEND NC1 (N) STEEL MAST ARM (N) LUMINAIRE N1 N C 2 NC3 (E) LANDSCA P E BOLLINGER R O A D 31 ' - 5 " ± B A C K O F P O L E TO N E A R E S T A D J . BU I L D I N G NC4 (E) BUILDING SECTOR AZIMUTH 100 5G A N2 NOTE: 1. FIBER PULLBOX EXACT LOCATION TO BE VERIFIED IN FIELD 2. CITY SERVICE PULLBOX AT POC TO BE LOCATED WITHIN 10' FROM PG&E VAULT 3. UPON COMPLETION OF CONSTRUCTION, RESTORE LANDSCAPE AND IRRIGATION TO LIKE OR BETTER CONDITION, TEST IRRIGATION. 4. UPON COMPLETION OF CONSTRUCTION, NOTIFY THE CITY OF NEW STREETLIGHT INSTALLATION SO THAT NEW BADGE ID NUMBER CAN BE PLACED BY THE CITY ONTO THE NEW STREETLIGHT POLE 2ENLARGED POC PLAN NTS SCALE (N) PG&E TRENCH, SEE DETAIL 8/E-3 (N) CONDUIT TRENCHING, SEE DETAIL 1/D-4 (E) WOOD UTILITY POLE (N) PG&E PULLBOX (N) CITY SERVICE PULLBOX (E) CURB (N) 2'-6" x 4'-0" x 6" THICK CONCRETE CAP PER CITY STANDARDS 6" MIN. NOTE: CARRIER GROUND WIRE TO BE LABELED VERIZON IN CITY ELECTRIC PULLBOX 2 A-1 ENLARGED POC PLAN (E) DOWN GUY (N) CONDUIT TRENCHING, SEE DETAIL 1/D-4 NC4 NC4 6' - 3 " ± C E N T E R O F PO L E T O F O C SECTOR AZIMUTH 280 5G B (E) FENCE (E) CONCRET E S I D E W A L K PROPERTY LI N E (E) LANDSC A P E (E) CONCRE T E S I D E W A L K PROPERTY LINE (E) LANDSCA P E (E) CONCRE T E S I D E W A L K PROPERTY LI N E (E) LANDSC A P E (E) DRIVEWAY, TYP. (E) CURB & GUTTER BOLLINGER R O A D (E) TREE,T YP. (E) FENCE WU N D E R L I C H DR I V E (E) MANHOLE, TYP. BOLLINGER R O A D REMOVE & REPLACE CONCRETE, APPROX. 25 SQ. FT. AT APPROXIMATE LIMITS TO MATCH EXISTING ADJACENT ELEVATIONS, REPLACE WHOLE FLAGS, NOT PARTIAL (E) BENCH / BUS STOP A.P.N.: 375-30-001 (E) ROAD SIGNS TO BE RELOCATED TO (N) STREET LIGHT POLE. (E) ROAD SIGN POLE TO BE REMOVED (E) TREE TO BE REMOVED (E) CO N C R E T E S I D E W A L K PROPE R T Y L I N E (E) LA N D S C A P E (E) BUS STOP SIGN REMOVE & REPLACE CONCRETE, APPROX. 25 SQ. FT. AT APPROXIMATE LIMITS TO MATCH EXISTING ADJACENT ELEVATIONS, REPLACE WHOLE FLAGS, NOT PARTIAL Contact Jerry Anderson, Cupertino at 650-921-6832, for streetlight ID labels; Use Cree RSWS-A-HT-2ME-5L-27K8-UL-GY-N-Q4 LED Luminaire (50 watt) for residential areas; Take photos of site before and after installation and submit to City. City spec photocell, RIPLEY 6390 LL-BL (BL for blue) CONTACT AND COORDINATE WITH VTA WHEN WORK AROUND THE BUS STOP. VTA MAIN # 408-321-2300 Place (N) PGE box here Place (N) city svc box here Maintain 15ft clear in front of bench DocuSign Envelope ID: FBF853B9-7C15-45A0-9521-09B9E65FD6F1DocuSign Envelope ID: 1865B63E-5505-4C24-9788-492799D18006 SHUTDOWN DRAWN BY: CHECKED BY:BPM APE IT IS A VIOLATION OF THE LAW FOR ANY PERSON, UNLESS THEY ARE ACTING UNDER THE DIRECTION OF A LICENSED PROFESSIONAL ENGINEER, TO ALTER THIS DOCUMENT 0 08/13/21 100% CD REV DATE DESCRIPTION MODUS, LLC 240 STOCKTON ST., 3RD FLOOR SAN FRANCISCO, CA 94108 APPROVED BY:LJB CA_SJ_CUPERTINO_313 VERIZON WIRELESS 2785 MITCHELL DRIVE, SUITE 9 WALNUT CREEK, CA 94598 (NEAR) 18660 NEWSOM AVE CUPERTINO, CA 95014 1 08/25/21 100% CD 2 09/15/21 100% CD PLAN CHECK A-2 EXISTING & PROPOSED ELEVATIONS 12PROPOSED ELEVATIONNOT USED 1/2"=1'-0" SCALE 1/2"=1'-0" SCALE EXISTING SURFACE 0'-0" AGL 2'-11" BACK OF POLE TO ROW LINE 4 D-2 (N) FOUNDATION (N) 10'-0" MAST ARM NOTES: 1. ALL NEW ANTENNAS, BRACKETS, AND OTHER EQUIPMENT WILL BE PAINTED TO MATCH LIGHT POLE. 2. ALL EXISTING SIGNAGE TO BE RELOCATED SHALL BE FASTENED USING 1/2" STEEL BANDING B.O. RELOCATED SIGNS 9'-2" AGL (N) LIGHT POLE (N) (2) 5G ANTENNAS IN FRP SHROUD 6 D-1 (N) FRP CONCEALMENT SHROUD 1 D-1 T.O. STEEL LIGHT POLE 29'-11" AGL RAD CENTER OF 5G ANTENNA 31'-7" AGL T.O. CONCEALMENT SHROUD 35'-6" AGL 8 D-1 3 E-3 B.O. DISCONNECT 7'-0" AGL T.O. DISCONNECT 8'-9" AGL (N) SMART METER / DISCONNECT w/ SHUTDOWN SIGNAGE 4 D-1 5 D-1 PORT HOLE LOCATION FOR DISCONNECT 1 D-2 T.O. RELOCATED SIGN 10'-8" AGL (E) RELOCATED ROAD SIGNS, HEIGHT TO BE VERIFIED WITH CITY INSPECTOR (N) LUMINAIRE 1 D-3 7 E-3 T.O. LIGHT SENSOR 31'-8" AGL (N) NOTICE SIGNAGE, TYP. OF (1) FACING STREETSIDE 9 D-1 T.O. NOTICE SIGNAGE 25'-2" AGL T.O. RELOCATED SIGN / B.O. RELOCATED SIGN 9'-11" AGL (N) CITY SPEC PHOTOCELL RIPLEY 6390 LL-BL DocuSign Envelope ID: FBF853B9-7C15-45A0-9521-09B9E65FD6F1DocuSign Envelope ID: 1865B63E-5505-4C24-9788-492799D18006 Certificate Of Completion Envelope Id: 1865B63E55054C249788492799D18006 Status: Completed Subject: CA_SJ_CUPERTINO_313/E5766467/Felipe Martinez Territory Approved 12-16-2021/VZ Manager to sign. Source Envelope: Document Pages: 7 Signatures: 4 Envelope Originator: Certificate Pages: 5 Initials: 0 felipe AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (UTC-08:00) Pacific Time (US & Canada) felipe.martinez@verizonwireless.com IP Address: 69.78.100.101 Record Tracking Status: Original 12/16/2021 1:27:58 PM Holder: felipe felipe.martinez@verizonwireless.com Location: DocuSign Signer Events Signature Timestamp Alba Barber alba.barber@verizonwireless.com Sr. Real Estate Manager Security Level: Email, Account Authentication (None)Signature Adoption: Pre-selected Style Using IP Address: 69.78.100.101 Sent: 12/16/2021 1:31:56 PM Viewed: 12/16/2021 2:18:17 PM Signed: 12/16/2021 2:22:39 PM Electronic Record and Signature Disclosure: Accepted: 12/16/2021 2:18:17 PM ID: 2023c1f0-a4fb-4e76-8a54-67cb16c6a8dc Christopher D. Jensen ChrisJ@cupertino.org Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 136.24.42.212 Sent: 12/16/2021 2:22:41 PM Viewed: 12/16/2021 2:24:36 PM Signed: 12/16/2021 2:24:55 PM Electronic Record and Signature Disclosure: Accepted: 12/16/2021 2:24:36 PM ID: 6456e531-5863-4b6b-88a7-233ff63ad6a6 Chad Mosley ChadM@cupertino.org City Engineer Security Level: Email, Account Authentication (None)Signature Adoption: Drawn on Device Using IP Address: 67.164.60.110 Sent: 12/16/2021 2:24:57 PM Viewed: 12/17/2021 2:34:07 PM Signed: 12/17/2021 2:34:20 PM Electronic Record and Signature Disclosure: Accepted: 12/17/2021 2:34:07 PM ID: a8c5787c-85e5-4b0f-8d34-b8a16441abe3 Kirsten Squarcia KirstenS@cupertino.org Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 162.245.20.145 Sent: 12/17/2021 2:34:22 PM Viewed: 12/17/2021 2:41:27 PM Signed: 12/17/2021 2:45:17 PM Electronic Record and Signature Disclosure: Accepted: 4/5/2021 1:36:36 PM ID: 7f043bd1-e00d-4922-961c-f3b1260d7968 In Person Signer Events Signature Timestamp Editor Delivery Events Status Timestamp Agent Delivery Events Status Timestamp Intermediary Delivery Events Status Timestamp Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp Alissa Ludtke alissa.ludtke@verizonwireless.com Coord-Operations Support Security Level: Email, Account Authentication (None) Sent: 12/16/2021 1:31:56 PM Electronic Record and Signature Disclosure: Accepted: 11/9/2021 11:45:12 AM ID: 70245b93-86b5-4791-a05c-2b960e68bbcf Araceli Alejandre Aracelia@cupertino.org Security Level: Email, Account Authentication (None) Sent: 12/16/2021 2:22:41 PM Viewed: 12/17/2021 10:59:28 AM Electronic Record and Signature Disclosure: Not Offered via DocuSign Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 12/16/2021 1:31:56 PM Certified Delivered Security Checked 12/17/2021 2:41:27 PM Signing Complete Security Checked 12/17/2021 2:45:17 PM Completed Security Checked 12/17/2021 2:45:17 PM Payment Events Status Timestamps Electronic Record and Signature Disclosure ELECTRONIC RECORD AND SIGNATURE DISCLOSURE From time to time, VBG Network Real Estate (we, us or Company) may be required by law to provide to you certain written notices or disclosures. 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