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2010-339027DOC# 2010-0339027 IIIIIIIIIIIIIIII 111111111111111111111111111111111111111111111111111111111 IN III JUL 06, 2010 3:55 PM Recording Requested By: City Engineer OFFICIAL RECORDS SAN DIEGO COUNTY RECORDER'S OFFICE DAVID L. BUTLER, COUNTY RECORDER FEES: 61.00 PAGES: 16 ~9 When Recorded Mail to: Cy Clerk illll1111111111 IN IN City of Encinitas 505 South Vulcan Avenue Encinitas, CA 92024 SPACE ABOVE FOR RECORDER'S USE AGREEMENT FOR MAINTENANCE OF PRIVATE STORMWATER TREATMENT AND STORMWATER POLLUTION CONTROL FACILITIES BY AGENT OF COMMERCIAL FACILITY V ✓f / ✓ APN: 260-640-25,26.27.28.&29 Project No.: 10523-GR Site Address:415-461 Santa Fe Drive, Encinitas, CA 92024 THIS AGREEMENT is between the City of Encinitas, a municipal corporation, hereinafter referred to as the "City", and K&K Lumber Co., Santa Fe Drive, LLC, and Safeway Inc., Vons Div., its heirs, successors, and assigns, collectively hereinafter referred to as "Owner", owner(s) of that certain real property hereinafter referred to as "Property" that is described in Exhibit "A", which is attached hereto and made a part hereof. This Agreement is for the periodic Maintenance of certain private stormwater treatment and pollution control facilities, hereinafter referred to collectively as "Stormwater Facilities". Stormwater Facilities include but are not limited to Best Management Practices (BMPs), Integrated Management Practices (IMPs), Low Impact Development (LID) features, Structural stormwater treatment devices, and drainage facilities. The description and plat of Stormwater Facilities is set forth in Exhibit "B" which is, attached hereto and made a part hereof. WHEREAS, this Agreement is required by the City as condition of approval of a City permit pursuant to City of Encinitas Municipal Code Chapter 20.08 and Chapter 23.24 as well as the City of Encinitas Stormwater Manual; and WHEREAS, the Stormwater Facilities benefit said Property and are used by Owner and his/her tenants their heirs, successors, and assigns; and WHEREAS, it is the desire of the City, the responsibility of the Owner and tenants, and to the benefit of the Public that Maintenance of said Stormwater Facilities occur on a regular and periodic basis as necessary to preserve the Storm Water Facilities in good-working order in accordance with the minimum Maintenance requirements set forth in Exhibit "C" which is attached hereto and made a part hereof and in accordance with the City of Encinitas Municipal Code, the Encinitas Stormwater Manual, and other related City policies and requirements; and WHEREAS, it is responsibility of the Owner to assure his/her tenants will comply with and enforce the terms and conditions of this agreement; WHEREAS, it is responsibility of the Owner to disclose this agreement to all the future tenants using, benefiting from, or impacting the Stormwater Facilities WHEREAS, it is responsibility of the Owner to add Maintenance of Stormwater Facilities to common area maintenance (CAM) and appoint a qualified property management company or individual herein after referred to as "Agent" to oversee such Maintenance. The Agent shall be the single point of contact between the City of Encinitas and Owners or Developer; and WHEREAS, the Owner may act as the Agent so long as the total square footage of the commercial facilities is less than twenty thousand square feet.; and WHEREAS, for the purpose of this agreement, Maintenance responsibilities mentioned on this agreement equally and collectively apply to Owner, tenants and the Agent; WHEREAS, it is requirement of development and or commercial use that this Agreement constitute a covenant running with the land, binding upon each successive owner of all or any portion of the Property into perpetuity. NOW THEREFORE, IT IS HEREBY AGREED FOR VALUABLE CONSIDERATION AS FOLLOWS: This agreement establishes the Owners' and tenants' Maintenance requirements for the Stormwater Facilities. The term "Maintenance" wherever capitalized in this agreement shall include, but shall not be limited to: inspection for purposes of identifying operational deficiencies in the Stormwater Facilities, routine upkeep and repair of the Stormwater Facilities in proper working order as determined by the City, and preparation and submittal of the annual inspection report to the City, all as set forth in subparagraph 1.i) through 1.iii). The Owner's ' requirements for providing Stormwater Facilities Maintenance as stated in this agreement shall mean Maintenance managed by the Agent, paid for by Owner, and performed by a qualified contractor, hired by the Agent on behalf of the Owner. i) The Owner shall inspect the Stormwater Facilities after all major storms. In addition, the Owner shall inspect the Stormwater Facilities at the minimum frequency specified in Exhibit "C", but not less than twice per year. ii) The Owner shall provide upkeep and repair to preserve the Stormwater Facilities in good working order and shall repair all deficiencies identified in the Owner's inspections no later than 30 days following the inspection or prior to the next anticipated rain event. Interim water quality control measures shall be utilized to protect damaged or deficient Stormwater Facilities during any storm event until such time as the Facilities are restored to good working order. The minimum upkeep and repair frequency shall be consistent with the Exhibit "C" but not less than once per year. To the satisfaction of the Director of Engineering Services, the Owner shall ensure that the Stormwater Facilities are in proper working order for the rainy season, which starts on October 1. iii) The Owner shall obtain the City of Encinitas Stormwater Inspection Report form from the City website or the City of Encinitas Civic Center, complete the inspection report form, and submit the inspection report to the City of Encinitas Department of Engineering Services. Prior to the submittal of the inspection report to the City, the Owner shall perform an inspection of the Stormwater Facilities, identify deficiencies, and repair and correct all deficiencies. The inspection report shall be submitted to the City once a year between August 1 and September 30. 2. The Property is benefited by this Agreement, and it is the purpose of the signatories hereto that this instrument be recorded to the end and intent that the obligation hereby created shall be and constitute a covenant running with the land. Any heirs, executors, administrators, assignees, and/or successors in interest to all or any portion of the Property, by acceptance of delivery of a deed and/or conveyance regardless of form, shall be deemed to have consented to and become expressly bound by these presents, including without limitation, the right of any person entitled to enforce the terms of this Agreement to institute legal action as provided in Paragraph 12 hereof, such remedy to be cumulative and in addition to other remedies provided in this Agreement and to all other remedies at law or in equity. 3. The Stormwater Facilities shall be constructed by and have Maintenance performed by the Owner in accordance with the term and conditions of this agreement and the plans and specifications identified in approved Grading Plan Number 10523-G which is on file as a permanent public record in the City of Encinitas. 4. The cost and expense of the Maintenance of the Stormwater Facilities shall be paid by the Owner. The owner is responsible to include necessary provisions in the lease agreement with any present and future tenants that cover the costs of all Stormwater Facilities Maintenance. 5. In the event the Property is subdivided in future, the owners, heirs, assigns, and successors in interest of each such newly created parcel(s) shall be liable under this Agreement for their then pro rata share of expenses reflecting such newly created parcels. 6. The Maintenance to be performed under this Agreement shall include upkeep, repair, and improvements to adequately ensure the Stormwater Facilities are in proper working order as determined by the City. Upkeep, repair, and improvements under this Agreement shall include, but are not limited to, repairing' access roadbeds; repairing, preserving, and providing improvement for the upkeep of drainage structures; removing debris, sediment, oil, grease, and other pollutants as determined by the City; perpetually preserving adequate groundcover and/or other erosion control measures within the Property in order to prevent erosion; and the management of materials, pollutants, and hazardous waste to prevent pollution of the stormwater system or Municipal Separate Stormwater Sewer System (MS4) as referenced in local and State codes. Upkeep, repair, and improvement shall also include other work necessary to repair and preserve the Stormwater Facilities for their intended purposes as well as the restoration of the Stormwater Facilities following any non-permitted modification. The restoration shall be as required to restore the Stormwater Facilities to the condition existing prior to damage or alteration. 7. Under no circumstances shall any contract or agreement for service(s) to be provided as outlined in this agreement, and any additional Maintenance activities or services to be provided as outlined in subsequent attachments hereto, be terminated by the Owner, tenants, or Agent unless a replacement contract or agreement for the required Maintenance has already been executed. The Agent and the Owner shall be responsible for ensuring proper execution of the provisions of all contracts and/or agreements for the required Maintenance and for timely payments for said services. 10. Any liability of the Owner, tenants, or Agent for personal injury to any worker employed to provide Maintenance under this Agreement, or to third persons, as well as any liability for damage to the property of any third persons, as a result of or arising out of Maintenance under this Agreement, shall be borne by the Owner, tenants, or Agent. 11. Owner and tenants shall jointly and severally defend, indemnify, and hold harmless City, City's engineer, its consultants, and each of its officials, directors, officers, agents, and employees from and against all liability, claims, damages, losses, expenses, personal injury, and other costs, including costs of defense and attorney's fees, to any contractor, any subcontractor, any user of the Stormwater Facilities, or to any other third persons arising out of or in any way related to the use, Maintenance, or the failure to provide Maintenance of the Stormwater Facilities. This Agreement imposes no liability of any kind whatsoever on the City and the Owner agrees to hold the City harmless from any liability in the event the Stormwater Facilities fail to operate properly. 9. Nothing in this Agreement, the specifications, other contract documents, the City's approval of the plans and specifications, or the City's inspection of the work constitutes an acknowledgement of any City responsibility for any such item or the material contained therein, and the City, City's engineer, its consultants, and each of its officials, directors, officers, employees and agents, shall have no responsibility or liability therefore. 10. The Owner and tenants shall provide access to the Stormwater Facilities'within the Property to the City's inspectors, employees, agents, and contractors within 48 hours of receipt of a written notification by the City. The access shall be provided unconditionally and without any obstruction, interference, or hazard. Any animals kept on the Property shall be secured outside of the area subject to the City's inspection. 11. The Owner hereby grants permission to the City, its authorized agents, and its employees, to enter upon the Property and to inspect the Stormwater Facilities following a 48-hour notice whenever the City deems necessary. The purpose of inspection is to evaluate the condition and performance of the Stormwater Facilities, to follow-up on reported deficiencies, to respond to citizen complaints, and/or to comply with State and City requirements for City inspection of such Facilities. The City shall provide the Owner with copies of the inspection findings and a directive to commence with any repairs deemed necessary. 12. In the event the Owner and tenants fail to preserve the Stormwater Facilities in good working condition as determined by the City Engineer, the City, its agents, employees, or its contractors, may enter upon the Property and take the steps deemed necessary to correct deficiencies and shall charge the costs of such repairs to the Owner. In the event the City pursuant to this Agreement, performs work of any nature, or expends any funds for attorney's fees, administrative costs, contractors, employees, consultants, materials, or other costs in the performance of said work, the Owner shall reimburse the City. Such reimbursement shall be due within thirty (30) days of receipt of a notification for all costs incurred by the City, including any administrative costs and attorney's fees. If said funds are not paid by the Owner within (30) days, City reserves the right to take legal action for cost recovery and to file with the County Recorder of San Diego County an assessment lien on the Property. It is expressly understood and agreed that the City is under no obligation to perform Maintenance of said Stormwater Facilities, and in no event shall this Agreement be construed to impose any such obligation on the City. 13. The terms of this Agreement may be amended in writing following the Owner request and upon written approval by the City Engineer. 14. This Agreement shall be governed by the laws of the State of California. In the event that any of the provisions of this Agreement are held to be unenforceable or invalid by any court of competent jurisdiction, the validity, and enforceability of the remaining provisions shall not be affected thereby. IN WITNESS HEREOF, the Parties have executed this Agreement. OWNER: Charles D. Fie [d III, AIA Field Architectural Corporation, Inc. 13854 Granville Drive Poway, CA 92064 As Agent For: K & K Lumber Co. A California Corporation 145 S. Fairfax Avenue, 4th Floor Los Angeles, CA 90036 Safeway Inc., Vons Div. 618 Michilinda Avenue Arcadia, CA 91007 Dan Buoye Santa Fe Drive, LLC, A California Limited Liability Company 6101 Quail Valley Court, Suite C Riverside, CA 92507 Date Date Signature of OWNER must be notarized. Attach the appropriate acknowledgement. CITY F ENCINITAS: Peter Cota-Robles Director of Engineering Services --7//,/ Z'q Da e CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of J72 On,~& before me, Date personally appeared who proved to me on the basis of satisfactory evidence to be the person whose namee subscribed to the within instrument and acknowledged to me that(~ qehe/MI executed the same in znl~ h~l authorized capacity eeinstrument and that by signature on t the person(,<, or the entity upon behalf of which the APRIL GERMAN persoacted, executed the instrument. 5;K7ornrnisslon #E 1724236 / Z , Notary Public - California Son Diego County I certify under PENALTY OF PERJURY under the Comm. Febll,2011 laws of the State of California that the foregoing paragraph is true and correct. WITNE Signati Place Notary Seal and/or Stamp Above Signature O~N otary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached ooument Title or Type of Documenty~% Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer- Title(s): ❑ Individual ❑ Partner - ❑ Limited ❑ General Top of thumb here ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer - Title(s): ❑ Individual ❑ Partner - ❑ Limited ❑ General Top of thumb here ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Number of Pages: ©2008 National Notary Association - 9350 De Soto Ave., P.O. Box 2402 -Chatsworth, CA 91313-2402-www.NationalNotary.org Item #5907 Reorder: Call Toll-Free 1-800-876-6827 or invalid by any court of competent jurisdiction, the validity, and enforceability of the remaining provisions shall not be affected thereby. iN WITNESS HEREOF, the Parties have executed this Agreement. OWNER, Charles D. Fie d Ili, AIA Field Architectural Corporation, Inc. 13854 Granville Drive Poway, GA 92064 As Agent For: K & K Lumber Co. A California Corporation 145 S. Fairfax Avenue, 4th Floor Los Angeles, CA 94036 Safeway Inc., Vons Div. 618 Michilinda Avenue Arcadia, CA 91007 Dan Buoye Santa Fe Drive, LLC, A California Limited Liability Company 6101 Quail Valley Court, Suite C Riverside, CA 92507 e55tZ 10 Date -7 /2- Date Signature of OWNER must be notarized. Attach the appropriate acknowledgement. CITY OF ENCINITAS: Peter Cota-Robles Director of Engineering Services Date CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of Y6 O 69 j~ before me, /C"i 7X L7.) L_ ~1~Jru~iG$ /~~bYi~h^//d'lLit, Da Here Insert Name and Title of the Officer personally appeared :Doe,Aj d y~ Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the perso* whose name Is/ subscribed to~t within instrument and acknowle ged to me that heAl y executed the same in his/her/their authorized capacity(ies), and that by liis r signaturOm on the instrument the erso, or the entity upon behalf of which the RONALD L. PURKEY person acted, executed the instrument. Commission# 1770321 Notary Public - Cullfornia = Z Riverside County I certify under PENALTY OF PERJURY under the ivlyccrnm.Expires Oct24,2011 laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature: °2 4 Place Notary Seal Above OPTIONAL i ure of Notary P is Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Docy+i~ent Title or Type of Document: 7'+nCdlr] ~ fy--)~ 0~~y ~n02T Document Date: Signer(s) Other Than Named Above: _ Capacity(ies) Claimed by Signer(s) Number of Pages: Signer's Name: ❑ Corporate Officer- Title(s): ❑ Individual ❑ Partner- ❑ Limited ❑ General Top of thumb here ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer - Title(s): ❑ Individual ❑ Partner - ❑ Limited ❑ General Top of thumb here ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 0 2009 National Notary Association • NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907 EXHIBIT `A' Legal Description of Property THAT PORTION OF THE NORTHWEST QUARTER OF SECTION 22, TOWNSHIP 13 SOUTH, RANGE 4 WEST, SAN BERNADINO MERIDIAN, IN THE CITY OF ENCINITAS, COUNTY OF SAN DIEGO, STATE OF CALIFORNIA PARCEL 2 OF PARCEL MAP NO. 1645, IN THE CITY OF ENCINITAS, COUNTY OF SAN DIEGO, STATE OF CALIFORNIA, FILED IN THE OFFICE OF THE COUNTY RECORDER OF SAN DIEGO COUNTY, JUNE 20, 1973, AS FILE NO. 73-169592, OF OFFICIAL RECORDS PARCEL 1 OF PARCEL MAP NO. 1645, IN THE CITY OF ENCINITAS, COUNTY OF SAN DIEGO, STATE OF CALIFORNIA, FILED IN THE OFFICE OF THE COUNTY RECORDER OF SAN DIEGO COUNTY, JUNE 20, 1973, AS FILE NO. 73-169592, OF OFFICIAL RECORDS 0'-J I. 141, 090 yP "X0 I ~i,~ ; / oel 1 I I . y? I I i I 1 o ~ s s s,~ I 44 't 7 L6 y m t I I t 1 Q 70- W Q W Q :z Ui a U o ~U-l o J m QW W QZ Q O W 0 m ~d W J 3 m J a a o Z z CO Q co cn a ~ H 000 w O -yT~i r EXHIBIT `C' Minimum Maintenance Requirements for Stormwater Facilities Bioretention Areas To preserve bioretention performance, the cells must be maintained. Like any landscape feature, bioretention areas must be pruned, mulched, and even initially watered and limed. Grassed bioretention cells are usually mowed. The need for rapid establishment requires bioretention cells to be limed, if indicated by a soil test. Additionally, plants may need to be spot-fertilized to ensure growth and survival in low P soils. Watering the plants every 2 to 3 days for a month or two helps ensure vegetation survival. The frequency of these tasks varies seasonally, with more frequent maintenance required in summer than in winter. Maintenance tasks unique to bioretention include occasional removal of mulch and the top layer of fill soil. Because clogging occurs most frequently at the top of the soil column, the bioretention basin rarely needs to be completely excavated. However, this has been necessary when the bioretention cell was located in an unstable drainage area. BIORETENTION MAINTENANCE TASKS Task Frequency Maintenance Notes Pruning 1 - 2 times / year Nutrients in runoff often cause bioretention vegetation to flourish. Mowing 2 - 12 times / year Frequency depends upon location and desired aesthetic appeal Mulching 1 - 2 times / year Mulch accumulation reduces available water Mulch Removal 1 time / 2 - 3 years storage volume. Removal of mulch also increases surface infiltration rate of fill soil. 1 time / 2 - 3 days for first If droughty, watering after the Watering 1 - 2 months. Sporadically initial year may be required. after establishment. One time spot fertilization for "first year" Fertilization 1 time initially vegetation. Remove and Replace 1 time / year Within the first year, 10 percent of plants may die. Dead Plants Survival rates increase with time. Miscellaneous 12 times / year Tasks include trash collection, spot weeding, Upkeep and removing mulch from overflow device. Bio-Filters, Priority BMP Swales, and Landscape Areas The operational and maintenance needs of a Bio-filter Swale are: • Vegetation management to maintain adequate hydraulic functioning and to limit habitat for disease-carrying animals. • Animal and vector control. • Periodic sediment removal to optimize performance. • Trash, debris, grass trimmings, tree pruning, and leaf collection and removal to prevent obstruction of a Swale and monitoring equipment. • Erosion and structural maintenance to prevent the loss of soil and maintain the performance of the Swale. Functional Maintenance Functional maintenance has two components: Preventive maintenance Corrective maintenance Preventive Maintenance Preventive maintenance activities to be instituted at a Bio-filter Swale are: • Trash and Debris. During each inspection and maintenance visit to the site, debris and trash removal will be conducted to reduce the potential for inlet and outlet structures and other components from becoming clogged and inoperable during storm events. • Sediment Removal. Sediment accumulation, as part of the operation and maintenance program at a Swale, will be monitored once a month during the dry season, after every large storm (0.50 inch), and monthly during the wet season. Specifically, if sediment reaches a level at or near plant height, or could interfere with flow or operation, the sediment will be removed. If accumulation of debris or sediment is determined to be the cause of decline in design performance, prompt action (i.e., within ten working days) will be taken to restore the Swale to design performance standards. Removal of Standing Water. Standing water must be removed if it contributes to the development of aquatic plant communities or mosquito breeding areas. • Fertilization and Irrigation. The vegetation seed mix has been designed so that fertilization and irrigation is not necessary. Fertilizers and irrigation will not be used to maintain the vegetation. • Elimination of Mosquito Breeding Habitats. The most effective mosquito control program is one that eliminates potential breeding habitats. Corrective Maintenance Corrective maintenance is required on an emergency or non-routine basis to correct problems and to restore the intended operation and safe function of a Bio-filter Swale. Corrective maintenance activities include: • Removal of Debris and Sediment. Sediment, debris, and trash, which impede the hydraulic functioning of a Swale and prevent vegetative growth, will be removed and properly disposed. • Structural Repairs. Once deemed necessary, repairs to structural components of a Swale and its inlet and outlet structures will be done within 10 working days. • Embankment and Slope Repairs. Once deemed necessary, damage to the embankments and slopes of Swales will be repaired within 10 working days). • Erosion Repair. Where a reseeding program has been ineffective, or where other factors have created erosive conditions (i.e., pedestrian traffic, concentrated flow, etc.), corrective steps will be taken to prevent loss of soil and any subsequent danger to the performance of a Swale. There are a number of corrective actions than can be taken. These include erosion control blankets, riprap. Hazardous Waste Suspected hazardous wastes will be analyzed to determine disposal options. Hazardous wastes generated onsite will be handled and disposed of according to applicable local, state, and federal regulations. A solid or liquid waste is considered a hazardous waste if it exceeds the criteria list in the CCR, Title 22, Article 11. Pervious Concrete Maintenance of pervious concrete pavement consists primarily of prevention of clogging of the void structure. In preparing the site prior to construction, drainage of surrounding landscaping should be designed to prevent flow of materials onto pavement surfaces. Soil, rocks, leaves, and other debris may infiltrate the voids and hinder the flow of water, decreasing the utility of the pavement. Vacuuming annually or more often may be necessary to remove debris from the surface of the pavements. Other cleaning options may include power blowing and pressure washing. Pressure washing of a clogged pervious concrete pavement has restored 80% to 90% of the permeability in some cases. It also should be noted that maintenance practices for pervious concrete pavements are still being developed. CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT State of California County of Jaw O before me, A~ 4'. , 1440yje WD/may ~~J~~-✓G Date Here Insert Name and Title of the Officer personally appeared Pi/ ,aloz" who proved to me on the basis of satisfactory evidence to be the person (s) whose name(s is re subscribed to within instrument and acknowledged me tha he/they executed the same in hi er/their authorized capacity(ies), and that by 0 RANDA G. MILLJOUR is er/their signature(s) on the instrument the Commission 41709664 erson(s), or the entity upon behalf of which the Notary Public - person(s) acted, executed the instrument. San Diego county Illy Commission Exp. Jan. 6, 2011 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature: .~olec/ ~ ~J Place Notary Seal Above Signa of Notary Publi OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer - Title(s): ❑ Individual ❑ Partner - ❑ Limited ❑ General Top of thumb here ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Number of Pages: Signer's Name: ❑ Corporate Officer - Title(s): ❑ Individual ❑ Partner - ❑ Limited ❑ General Top of thumb here ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 0 2009 National Notary Association • NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907