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HomeMy WebLinkAboutRES 2016-15RESOLUTION NO. 2016- 15 A RESOLUTION OF THE CITY COUNCIL OF DIAMOND BAR ACCEPTING A QUITCLAIM DEED AND IRREVOCABLE OFFER OF DEDICATION FROM THE WALNUT VALLEY UNIFIED SCHOOL DISTRICT FOR PUBLIC USES WHEREAS, the Walnut Valley Unified School District Board of Directors has approved an Irrevocable Offer of Dedication and Quitclaim Deed relating to properties to be used by the City of Diamond Bar ("City") for park and street purposes, copies of which are attached hereto, respectively, as Exhibits "A" and "B"; WHEREAS, pursuant to Government Code § 27281, prior to recording either document the City is required to evidence its acceptance of any interest in real property by either a certificate or resolution of acceptance by the City Council of the City of Diamond Bar ("City Council'). NOW, THEREFORE BE IT RESOLVED that the City Council of the City of Diamond Bar does hereby find and determine as follows: 1. That in accordance with Government Code § 27281 that the interests in real property conveyed by the Irrevocable Offer of Dedication and Quitclaim Deed, attached hereto respectively as Exhibits "A" and "B", are hereby accepted by the City Council and further that the Mayor of the City is authorized to execute, and the City Clerk to attest to, a certificate of acceptance for both interests. APPROVED AND ADOPTED this 3rdth day of May, 2016. 4cy iA. Lyons, 1ayor I, TOMMYE A. CRIBBINS, City Clerk of the City of Diamond Bar, do hereby certify that the foregoing Resolution was passed, approved and adopted at a regular meeting of the City Council of the City of Diamond Bar held on the 3rd'h day of May 2016, by the following vote: AYES: COUNCIL MEMBERS: Herrera, Low, Tye, MPT/Lin, M/Lyons NOES: COUNCIL MEMBERS: None ABSENT: COUNCIL MEMBERS: None ABSTAIN: COUNCIL MEMBERS: None Tommye K Cribbins, City Clerk City of Diamond Bar 1155228.1 2016-15 LXl}IE>IT" A RECORDING REQUESTED BY; WALNUT VALLEY UNIFIED SCHOOLDISTRICT AFTER RECORDING PLEASE RETURN TO; CITYOF DIAMOND BAR 21825 -Copley Drive Diamond Bar, CA 91765 Attention: City Attorney THIS DOCUMENT 1S EXEMPT FROM RECORDING FEES PURSUANT TO SECTION 27383 OF THE CALIFORNIA GOVERNMENT CODE, (Space aboveLine forReeorder's Use Only) IRREVOCABLE OFFER OF DEDICATION FOR VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, Walnut Valley Unified SchoolDistrictrepresents that, as the owner of the herein -described real property ("Grantor"), Grantor hereby makes an Irrevocable Offer of Dedication of fee interest to the City of Diamond Bar ("City") the hereinafter described real property for the following public purpose: PARK SITE The real property referred to above is situated in the City of Diamond Bar; County of Los Angeles, State of .California, as more particularly described in,Exhibit "A" and depicted on Exhibit 'B" both of which are attached hereto, This offer of dedication of fee interest shall be irrevocable and shall be binding on the Grantor, its heirs, executors, administrators, successors and assigns, The property dedicated herein is on an "AS -1S" basis and Grantor makes no representation or warranty of any kind regarding the condition of the Grantor's property. The property dedicated herein is subject to all existing easements, covenants, and restrictions recorded against the Grantor's property. WITNESS WHEREOF, Grantorhas executed this Irrevocable Offer of Dedication of f'y2,/, n20Z2016. WALNUT VALLEY UNIFIED SCHOOL DISTRICT By: Michael R. odson Its: Assistant Superintendent, Business Services 005254.00067 13457822.1 CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate' verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California } County of Lf>s Pthgn—c ks On khruar I -AO i� before me, 301 & F.) Nokivv �t hltc I ere nsan manna a Dior personally appeared MCN# e l i WSon 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(a) 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. JULIE E. WHISENANO Commission #2022705 WITNESS my hand and official seal: Notary pulifa-c1eto"011 Los Artistes County n 10G4 MY Camra.E u 4 2017 'r�[,t�l,Aa�Q N4 ary P, blic Signature (Notary Public Seal) OF THE ATTACHED DOCUMENT 00o ord%cdpUon of attached document) (Title or description of attached document continued) Number of Pages _ Document Date CAPACITY CLAIMED BY THE SIGNER ❑ Individual (s) 13 Corporate Offiicer- t, MCl/ ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Other 2019 Vetsiou v,',w.Notat �Clas<_es rmuh But-S7J 9865 INSTRUCTIONS FOR COMPLETING THIS FORM 7hisformcompliestvith eanent Calffondasfandesregordingnota,ytvordingand. ifneeded. should be completed and atlached to the docament. dcbrowledgmenls from oikerstates may be compleledfor documents being sent to thal slate so long. as the. wording does not require. the California notary to violate California notary law. • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. •. Date of notarization must be the date that the signer(s) personally appeared which must also be the same date the acknowledgment is completed. • The notary publicmust print his or her name as it appears within his or her commission followed by a comma and then your title tnomry public). •. Print Ore annals) of document signer(s) who personally appear at the time of notarization. • Indicate the correct singularor, plural forms by crossing off incorrect forms (i.e. lie/she/dheyr is /are) or circling the correct forms. Failure to correctly indicate this information may lead to rejection of document recording., •.'the notary seat impression must be clear and photographically reproducible. Impression must not cover text or lines, If seal impression smudges, re-sealif a sufficient area permits, othowise complete a different acknowledgment form. • Signature of the notary public must match the signature on file with tire office of information is not required but could help to ensure this Indicate title or We of attached document, number of pages and date. Q Indicate the capacity claimed by the signet. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document with a staple.. EX VISIT "N' LEGAL DESCRIPTION OR, RARKSITE bROICATION REF:B-11 10-21-15 page 5 BY QUITCLAIM RECORDED AUGUST 22, 1972 AS UNTO THE THAN $00 SAID SAID SUBSTANCES, A5 RESERVED IN THE DECD REF; &it 10.21-15 Page 8 RECORDED SEPTEMBER 8, 1988 AS INSTRUMENT NO.88-1430218. CONTAINING 6.83 ACRES OF LAND, MORE OR LESS. AS MORE PARTICULARLY SHOWN ON EXHism "B° (SKETCH), ATTACHED HERETO AND MADE A PART HEREOF. THIS LEGAL DESCRIPTION WAS PREPARED BY ME OR UNDER MY DIRECTION IN SEPTEMBER, 2016, AT THE REQUEST OF JCCL•SOUTH POINTE WEST, LCC, Rebell N. Mim Maul: Pt.S 631 �L My license expires: December 31,'2016 Dated: 09-Z - 119 Ld0215580,00LPROD0CTIOMEXHI]3nS\EXHIeIT A -PARK LGL•REVISEP.doc REF: B-11 10-21.16 Page 7 sW COR. LOT 7RP.o.C, TRACT 30893 %� '/- OOK 954 PAGEy�~ �y 16m1g m^Q 4�+oIz��`Y �I ekf civ 2�'ry q . ti PPR. LOT 49 BOOK '927 A=93'1D'S9'i N=50.00' L-61.32' 1 SCALE' 1'w100' r LEGEND: RO.C. INDICATES POINT OF 0% T.P,O.B. INDICATES TRUE POINT OF BEGINNING, INDICATES RECORD DATA PER TRACT 1J0. 32091, M8 897, 72-76 INDICATES OVERALL PARK SITE ARFA - v^® 6.83 AC. s1.... 99 SHEET I OF 2 ANY LEGAL PARKSXT \ LOT 72 TRACT 32091 )OK 897 PAGE 72-78 S.E. COR LOT 72, M4CT NO. 32091 RADIUS SBC. 17 k US, R9W �A Vj S.B,M. 4 56'. N'LY UNE SE0770M 20, 72S, R9W, S.B.M. NB9:50'45£ 1D21.06' N69'59'15'W _ ',9 8'28 00'4444 NZY LINE GDT 49, M40T W. a 39.576, 'MA 927. 28--31 TRACT 32576 N PAGES 28-31 49.61' NUML+L•R DELTA RADIUS ZGNGTN Ci 132902' 220.00' 59.77' C2 i8' 2"- 30.00' _ 41.22" C3 00'4444 282.00' 3.67' C4 M 44'25 ,'i7" ?5 0 19.38' _ AU_YBEARING DISTANCE Li N37'021t1: ] 5.13 REF: B-11 10-21-15 Page 8 RAC 72 TRACT N0: /) 32091 BOOK 897 PAGE 72-•78 EXHIBIT "B" SEC, 17 T2S, R9W CON LOT 72, aC B r N0. '3209 f SHEET 2 ®F 2 TUNE L4A'NSTONF DRNEE d=06'03'52° N'LYLINE SECIM20, 72S, R9Y1 SQAf.. A14�29"E,[RL f V7 N69'50'45"f 1021.06' (N89'51'1; w 81� NLY LINE LAT 49, TRACT N0. 9 9 32576, U.B. 07 28-31 N6 1 A POR. LOT 49 Standard :l� Area : 297e30:27 TRACT 32576; 12 4 q� ^-r-•- 53, 60 LP.0.6, INDICATES TRUE POINT Of HEGINNIN6. t� BOOK SCALA:• 1 "= f 00' z A l TUNE L4A'NSTONF DRNEE d=06'03'52° N'LYLINE SECIM20, 72S, R9Y1 SQAf.. A14�29"E,[RL f V7 N69'50'45"f 1021.06' (N89'51'1; w 81� NLY LINE LAT 49, TRACT N0. 9 9 32576, U.B. 07 28-31 N6 1 A POR. LOT 49 Standard :l� Area : 297e30:27 TRACT 32576; Numam RMING DISTANCE 12 -^-r—• AYi3'35 57 W ^-r-•- 53, 60 LP.0.6, INDICATES TRUE POINT Of HEGINNIN6. t� BOOK 927 _ INDICATES OVERALL PARK SITE AREA = _:-.. 6.83 AC, PAGE 28-31- h Oti N � Door 80.48'Ne 01 N6�Zg129�� N89dz r8 5s.5r N66'47'14W 56.97' N89'51'17"E H LOT 49 -� TRACT 32576 a BOOK 927 PAGE 28-..31 n 1dUM8ER DELTA RA01U5 1ENGTN LEGEND,- P.G.C. INDICAIES POW OF COMUFMCMEN1: Numam RMING DISTANCE 12 -^-r—• AYi3'35 57 W ^-r-•- 53, 60 LP.0.6, INDICATES TRUE POINT Of HEGINNIN6. t� N35'23 8.d6 _ INDICATES OVERALL PARK SITE AREA = _:-.. 6.83 AC, REF; B-11 10-21-16 Page 9 CERTIFICATE OF ACCEPTANCE OF OFFER OF DEDICATION This is to certify that the interest in real property conveyed by the irrevocable offer of dedication dated February 1, 2016, from Walnut Valley Unified School District to the City of Diamond Bar, California, ("Grantee") is hereby accepted by the undersigned officer on behalf of the Grantee pursuant to authority conferred by the City Council of the City of Diamond Bar on May 3, 2016, and the Grantee consents to recordation thereof by its duly authorized officer. Dated: May a,2016 Nancy A ons, Ma AtteL rr l Tommye ribbins,,Qity QIerk, , pro er 2as210 �. David DcBerry, City Att rney 1150220.1 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California ) County of LOS Ahfaa�S ) OnN/ - 00110 before me, LIAR+A LD60 taiWlo, AJgARy �z(C 1C, Date Here Insert Name and Title of the Officer personally appeared Name(s) of Signers) who proved to me on the basis of satisfactory evidence to be the person whose name(4 is/a�e subscribed to the within instrument and acknowledged to me that ho/she/1;P(ey executed the same in Vs/her/their authorized capacity(ivs), and that by hkher/th& signature(4 on the instrument the person(4, or the entity upon behalf of which the personN acted, executed the instrument. MARIA LOERA HILARIO rLAO Commission M 2135307 Notary Pu090 • California Loa An9aNa County Mi Comm. ExP49 Dae 25.2019 Place Notary Seal Above 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 r7f 1 AZl0. ���a o ftnature of Notary Public OPTIONAL is optional, completing this information can deter alteration of the document or idulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Number of Pages: Signer(s) Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Document Date: Named Above: ❑ Corpor to Officer — Title(s): El Partner — El Limited ❑ General ❑ IndividualAttorney in Fact El Trustee ElGuar2lia or Conservator ❑ Other: Signer Is Representing: 02014 National Notary Association - www.NationaiNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907 t✓x-+lair F> RECORDING REQUESTED BY: WALNUT VALLEY UNIFIED SCHOOLDISTRICT AFTER RECORDING PLEASE RETURN TO: CITY OF DIAMOND BAR 21825 Copley Drive Diamond Bar, CA 91765 Attention: City Attorney THIS DOCUMENT ISEXEMPT FROM RECORDING FEES PURSUANT TO SECTION 27383 OF THE CALIFORNIA GOVERNMENT CODE. (Space above Line forRecorder'sUse Only) QUITCLAIM DEED FOR VALUABLE CONSIDERATION, the receipt and legal sufficiency of which is hereby acknowledged, THE BOARD OF EDUCATION OF THE WALNUT VALLEY UNIFIED SCHOOL DISTRICT, the governing body of the Walnut Valley Unified School District ("Grantor"), does hereby remise, release, and forever quitclaim to the CITY OF DIAMOND BAR, California ("Grantee") any and all interest of Grantor in and to that certain real property (The "Property") located in the City of Diamond Bar, in the County of Los Angeles, State of California, depicted on Exhibit "A" attached hereto and as more particularly described in Exhibit "B" attached hereto. IN yRTNESS WHEREOF, Grantor has executed this Quitclaim Deed as of f h f�o101�. 2016. WALNUTVALLEYUNIFIE OOLDISTRICT By: Michael R. odson Its: Assistant Superintendent, Business Services 005259.00067 13457822.1 CALIFORNIA ALL- PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the Identity of the individual who signed the document to which this certificate is attached; and not the truthfulness, accuracy, or validity of that document. State of California } County of tom AhTl-es } On debruary Ii, UIf. before me, .Ttkk C. l- hitsenArtd;No%avvPiibltct ma nee home en n o o ea personally appeared JY�j P 1 t 4U5or, who proved to me on the basis of satisfactory evidence to be the person(e) 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 PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. A AlrrI - 0 r�r JULIE E. WISEN" EM 100111111114110.110 2022705 WITNESS my hand and official seal. qff Notary Public - C&Wornla Los AnOsks County. re Not4ry Public Signature (Notary Public Seal) (Title or descdplion of aHached document), (Title or description of anached documentcontineed) Pages Document Date CAPACITY CLAIMED BY THE SIGNER O Individual (a) ❑ Corporate Officer (Title) ❑ Partner(s) O Attorney -in -Fact ❑ Trustee(s) p Other 301:, V T..IUII m:r;l KAI 73418G!, INSTRUCTIONS FOR COMPLETING THIS FORM Thisformcomplieswh/r cunrnt Callfonatsstatutes regarding nofaly wording and, if needed should be completed and atrached to the document. Acknowledgments from other states may becomplaed for docmuents being sem to rho? stare so long. as the wording does nor require. the California notary to violate Caitfornia nmai), law. •. State and County intervention must be the State and County where the document signer(s);personally appeared before the notary public for acknowledgment. • Data or notarization most be the date dint the signer(s) personally appeared which must else be due same dale the acknowledgment is completed. • The notary public must pant his or her name as it appears within his or her comm(ssionfollowed by o comma and then your title (notary public). • Print; the names) of document signers) who personally appear at the time; of notarization. • Indicate the coned singular or plural fonts by crossing off incorrect forms (i.e. halsheltheyr is /are) or cimling the etirtcct fonts. Failure to correctly indicate this information may lead to rejection of document recording. • The notary seal impression mustbe clear and.. photographically reproducible. Impression must not cover text or lines. If seal impression smudges, re -seal if a sufficient area permits, otherwise complete a different acknowledgment form, • Signal= of the notary public most match the signature on file with the office of the county clerk. 4 Additional information is not required but could help toensure this acknowledgment is not misused or attached to a different document. Indicate title or type of attached document, number of pages and date. J Indicate die capacity claimed by the signer. If the claimed capacity is. a corpomlc oniceg indicate the title (i.e. CEO, CFO, Secretary). • Securely stanch this docmnenl io the signed document with a suple. EXHIBIT "A" LEGAL DESCRIPTION FOR ROAD DEDICATION 2 SOUTH, RANGE 9 WEST, SAN CIAL PLAT OF SAID LAND, ALL IN THE �, DESCRIBED AS FOLLOWS;; BEING A 60.00 -FOOT WIDE STRIP OF LAND LYING 30.00 FEETEACH SIDE OF THE FOLLOWING DESCRIBED CENTERLINE: COMMENCING AT THE MOST SOUTHERLY CORNER OF LOT 72 OF TRACT NO. 32091, AS PER MAP RECORDED IN BOOK 897, PAGES 72 TO 78 INCLUSIVE, OF MAPS, IN THE OFFICE OF THE COUNTY RECORDER OF SAID COUNTY; THENCE ALONG THE SOUTHEASTERLY LINE OF SAID LOT 72, NORTH 31°02'20" EAST, 30.00 FEET TO THE TRUE POINT OF BEGINNING; SAID POINT ALSO BEING THE BEGINNING OF A NON - TANGENT 360.00 -FOOT RADIUS CURVE CONCAVE NORTHERLY, A RADIAL LINE PASSING THROUGH SAID POIT BEARS SOUTH 31°02'20"WEST; THENCE EASTERLY ALONG THE ARC OF SAID CURVE THROUGH A CENTRAL ANGLE OF 34030'50'A DISTANCE OF 216.86 FEET; THENCE NORTH 86°31'30" EAST 247,55 FEET TO THE BEGINNING OF A TANGENT CURVE CONCAVE NORTHWESTERLY HAVING A RADIUS OF 800.00 FEET; THENCE NORTHEASTERLY ALONG THE ARC OF SAID CURVE THROUGH A CENTRAL ANGLE OF 06003'62" A DISTANCE OF 84.68 FEET TO THE POINT OF TERMINUS OF SAID STRIP OF LAND. THE SIDELINES OFTHE ABOVE-DESCRIBED 60:00 -FOOT WIDE STRIP OF LAND SHALL BE SHORTENED OF LENGTHENED SO AS TO TERMINATE WESTERLY IN THE EASTERLY LINE OF SAID LOT 72 AND A LINE RADIAL TO LAST -SAID CURVE AT THE POINT OF TERMINUS OF SAID STRIP. CONTAINS 0.756 ACRES, MORE OR LESS AS MORE PARTICULARLY SHOWN ON EXHIBIT "B" (SKETCH), ATTACHED HERETO AND MADE APART HEREOF. THIS LEGAL DESCRIPTION WAS PREPARED BY ME OR UNDER MY DIRECTION IN SEPTEMBER, 2015, AT THE REQUEST OF JCCL-SOUTH POINTE WEST, LLC. Robert N. Mim Mack PLS 5314 My license expires: December 31, 2015 Dated: O 9 - 28 - /S TTG Engineers - Ontario Office' L:\0215558.00\iroductlonlexhlbltslExhiblt A -Road Legal.doo SCALE. 0-400' EXHIBIT "B" SKETCH TO ACCOMPANY LEGAL 3SCRIPTION FOR ROAD DEDICATION SEC, 17 o6AQ0y T2S, R9W S.B.M. h v cl fhb /LOT 72 TRACT .32091 M8 897/72-78 pR 3�4000a1g/gci E��O 60.0 0 00'2(RAD� j--' TP. yOdti16 J /TP.O.B269,51 , R po"�39 kg3 / y�tiy, '401 269,611 14115U 7klV R'23 M58i a (M. S.E. COR. LOT 72/ US 897, 72-78 S'LY. LINE LOT 72 MB 897, 72-78 LEGEND: P.O.C. INDICATES POINT OF COMMENCEMENT. T.P.O.B. INDICATES TRUE POINT OF BEGINNING. P.O.T. INDICATES POINT OF TERMINUS. INDICATES RECORO DATA PER 7R4CT 32091, M.B. 897, 72-78 CERTIFICATE OF ACCEPTANCE OF QUITCLAIM DEED This is to certify that the interest in real property conveyed by the quitclaim deed dated February 1, 2016, from Walnut Valley Unified School District to the City of Diamond Bar, California, ("Grantee") is hereby accepted by the undersigned officer on behalf of the Grantee pursuant to authority conferred by the City Council of the City of Diamond Bar on May 3, 2016, and the Grantee consents to recordation thereof by its duly authorized officer. Dated: May 11, 2016 1150219.1 �al)dq Nancy A. yo s, Mayor Attndt: r a� Tommye 1,ribbinS ;Pity Clerk, CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California ) County of 43 AdW,6S ) OnMANS P , a -`t before me, IgAOA L06PA 0)LAPj0 , IJo7AP-\1)0 jiC.. Date Here Insert Name and Title of the Officer personally appeared Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(4 whose name(o is/p/e subscribed to the within instrument and acknowledged t me that Wshe/th'ey executed the same in hi /her/their authorized capacity(ios), and that by his/her/th6iir signature($] on the instrument the person(41 or the entity upon behalf of which the person 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. ----------------- MARIA LOERA HILARIO WITNESS my hand and official seal. commission # 2135307 Notary Public • California / Los AnpelesCountySignatureil�y u M Co.nusIns Doc252019t V WignatureofNotary Public Place Notary Seal Above OPTIONAL 9I section is optional, completing this information can deter alteration of the document or frgudulent reattachment of this form to an unintended document. Description of Attached Doment Title or Type of Document: c�!— Number of Pages: Signer(s) Document Date: Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signers Name: ❑ Corobrate Officer — ❑ Partner — El Individual ❑ Trustee ❑ Other: _ Signer Is Representing: Title(s): I ❑ General ttornev in Fact ❑ Gilardian or Conservator ©2014 National Notary Association • www.NationaiNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907