HomeMy WebLinkAboutContracts & Agreements_10-2002_CCv0001.pdf Recorded in Official Records,County of San Bernardino 4/08/2002
LARRY WALKER 04 PM
RECORDING REQUESTED BY {,^ L04
AND WHEN RECORDED MAIL TO: cfinrrry'"
;��nff"APT Auditor/Controller — Recorder
R Regular Mail
CITY CLERK
CITY OF REDLANDS Dock 2002_01714$0 Titles: 1 Pages: 1
35 CAJON STREET
P.O. BOX 3005 ( Fees 0.00
REDLANDS CA 92373 ` Taxes 0.00
Other
0.00
PAID $0.00
SPACE ABOVE THIS LINE FOR RECORDER'S USE FEES NOT REQUIRED
PER GOVERNMENT CODE
NOTICE OF COMPLETION SECTION 6103
Notice pursuant to Civil Code Section 3093,this notice must be filed within 10 days after completion of work. Notice is hereby
given that:
1. The undersigned is owner or corporate officer of the owner of the interest or estate stated below in the property hereinafter described:
2. The full name of the owner is: CITY OF REDLANDS
3. The full address of the owner is: 35 CAJON STREET, P O BOX 3005
REDLANDS CA 92373
4. The nature of the interest or estate of the owner is; In fee.
5. The full names and full addresses of all persons,if any,who hold title with the undersigned as joint tenants or as tenants in common are:
NOT APPLICABLE
;�. 6. A work of improvement on the property hereinafter described was completed on March 11,2002. The work done was:
Replacing incandescent traffic signal lights with light emitting diode modules.
7. The name of the contractor for such work of improvement was: L. A. Signal, Inc.
15100 E.Nelson Ave. January 15, 2002
Industry CA 91744 (Date of Contract)
8. The property on which said work of improvement was completed is in the City of Redlands,County of San Bernardino,State of California,
and is described as follows:City of Redlands Traffic Signals within City right-of-way at various street intersections.
9, The street address of said property is:Various street intersections
Dated:March 18,2002
Civil Engineer,Public Works Department,CitypKedlands
VERIFICATION
1, the undersigned,say I am the Public Works Director of the declarant of the foregoing Notice of Completion,and have read said Notice of
Completion and know the contents thereof;the same is true of my own knowledge.
I declare under penalty of perjury that the foregoing is true and correct.
Executed on October 17, 2001,at Redlands,California.
Public Works Director,Public Works Dep nt,City of Redlands
AGREEMENT
THIS AGREEMENT, made and entered into this 15th nd/th day of January , 2002, by and
between the City of Redlands, a Municipal Corporation, organized and existing under the laws of the State
of California, hereinafter referred to as the "City", and
A Lp 6-
a partnership consisting of
or an individual trading as
of the City of—:rvr� County of e-.I e
State of California, hereinafte'r`referred to as the "Contractor".
WITNESSETH: That the City and the Contractor, for the consideration hereinafter named, agree as
follows:
I. SCOPE OF WORK: The contractor will furnish all materials and will perform all of the work for
the following:
To perform construction of LED Signal Module project, complete, all as shown, specified, and made
a part of Contract No. 101302-7150/140006,
2. THE CONTRACT SUM OF: $39,960.00
3. TIME FOR COMPLETION: The work shall be completed within thirty (30) work days from and
after the date of the Notice to Proceed.
4. CONTRACT DOCUMENTS: The complete contract includes all of the contract documents set forth
herein, to wit; Notice Inviting Bids, Instructions to Bidders, Proposal and Bid Forms, Bid Bond,
Agreement,Performance Bond, Payment Bond,Plans and Specifications, all referenced specifications,
and any Addenda thereto,
5. ATTORNEY FEES: In the event any legal action is commenced to enforce or interpret the terms
or conditions of this contract the prevailing party shall, in addition to any costs and other relief, be
entitled to recovery of its reasonable attorney's fees.
6. DEFENSE OBLIGATION: The contractor shall defend the City, its elected officials, officers,
agents, and employees from and against any and all claims, losses, damages, and causes of action,
including death, brought by any person or persons for or on account of any wrongful or negligent act
or omission of the contractor. its employees or agents in connection with the wrongful
of the
contractor's obligation under this contract.
7. INSURANCE: All policies of insurance required by this contract shall name the City, its elected
officials, employees, and agents as additional insureds, and such insurance shall be primary with
respect to such additional insureds and non-contributing to any insurance or self-insurance maintained
by the additional insureds.
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IN WITNESS WHEREOF, the parties hereto have executed this Agreement in duplicate on the day and
year first written above.
CITY SEAL
By: 2614�
Mayor, City of R dlands
County of San Bernardino, California
ATTEST:
City Clee&, City of Re aV
County of San Bernar n alifornia
A � i ai
Name of Contractor
rl
CONTRI.CTQR SEAL By;
Signature f uthorized Agent
O e .CA
Signatory's Title
Signature of Authorized Agent (if necessary)
Signatory's Title (if necessary)
Contractor's License No.
CD-1&
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
ss.
County of LOS ANGELES
On before me, RAMON C. ARTEAGA
Date Name and Title of officer(e.g.,"Jane Doe.Notary Public")
personally appeared RAYMOND C. MORALES JR.
Name(s)of Signer(s)
16' �personally known to me
6 wl 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.
WIT t ESS my hand and offici I se
71
Place Notary Seal Above Signature of Nota Publ c
OPTIONAL
Though the information below is not required by law, it may prove valuable to persons relying on the document
h? and could prevent fraudulent removal and reattachment of this form to another document.
F` Description of Attached Document
Title or Type of Document:
� Document Date: Number of Rages: �
� Signer(s)Other Than Named Above:
Capacity(ies) Claimed by Signer
Signer's Name:
;.. .
Individual ;
h —`
immTop-olf
Corporate Officer=-Title(s): pjE_SjDENT/SE{'RETARY TREA RE
El Partner— Limited General i
D Attorney in Pact E
Trustee
Guardian or Conservator
Other: 4
Signer Is Representing:
-------------6
-C,1997 Na€ivnai Notary Association-9350 De Soto Ave_,P.o,Box 2402.0hatsworth,CA 91313-2402 Prod_No,58017 Reorder Gall Toll-t=ree 1,-800 876-6827
EXECUTED IN TRIPLICATE BOND NO.5881135
PREMUM: $288.00
PEUCIRMANCE BOND
WHEREAS, the City Council of the City of Redlands, State of California (hereinafter designated as
City), and _.LA.-SIGNAL, INC, (hereinafter designated as Principal)have entered into
an agreement whereby Principal agrees to install and complete certain designated public improvements,
which by said agreement dated_, 2002, and identified as Contract No: 101302-7150/140046,
is hereby referred to and trade a part hereof; and
WHEREAS, under the terms of said agreement, Principal is required before entering upon the
performance of die work, to furnish a good and sufficient faithful performance bond wig the City.
NOW,THEREFORE, said Principal and the undersigned as corporate surety,are held and fitinly bound
unto the City in the sum of._THIRTY MINE THOUSAND NINE HUNDRED SIXTY dollars
($ -39..960 - ) for the payment of which sum well and truly to be trade, we bind ourselves,
our heirs, successors, executors and administrators,jointly and severally, firmly by these presents,
The condition of this obligation is such that if the above bounded Principal, his or her heirs, executors',
administrators,successors or assigns,shall in all things stand to and abide by, and well and truly keep and
perform the covenants, conditions, and provisions In the said agreement and any alteration thereof made
as therein provided, or his or her part, to be kept and performed at the time and in the manner therein
specified, and in all respects according to their true intent and meaning, and shall defend, indemnify and
save harmless the City,its elected officials,officers,agents,and employees, as therein stipulated,then this
obligation shall become null and void; otherwise it shall be and remain in full force and effect.
As a part of the obligation secured hereby and in addition the face amount specified therefor, there shall
be included costs and reasonable expenses and fees, including attorney's fees incurred by the City in
successfully enforcing such obligation, all to be taxed as costs and included in any judgement rendered,
The surety hereby stipulates and agrees that no change, extension of time, alteration or addition to the
terms of the agreement or to the work to be performed thereunder or the specifications accompanying the
same shall in anywise affect its obligations on this bond, and it does hereby waive notice of any such
change, extension of time, alteration or addition to the terms of the agreement or to the work or to the
specifications.
IN WITNESS WHEREOF, this instrument has been duly executed by the Principal and surety named,
on JANUARY 17, , 2002, Bond No, 5881135
ICA
L.A. SIGNAL, INC. (SEAL) FIRST NATIONAL INSURANCE COMPANY A SAIL
Principal Surety
By.
By: r
Sigt�tu Signatart �CH ON
Address; 26ATTORNEY—IN—FACT
77 N MAIN S RESET
SANTA ANA, CA 92705
(Notarial Acknowledgm nts of Principal and Surety) Telephone; ( 714 ) 437-3043
CD-148
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT No.5907
q 1;:
State of California
County of San Diego
On 01"17-02 before me, America San Martin, Notary Public
DATE NAME,TITLE OF OFFICER-E.G.,'JANE DOE,NOTARY PUBLIC'
personally appeared CHRISTINE A. PATERSON
NAME(S)OF SIGNER(S)
rX personally known to me - OR - D proved to me on the basis of satisfactory evidence
to be the person(g) whose name(r.) is/=
subscribed to the within instrument and ac-
knowledged to me thatA32VshelkmT executed
the same in his/her/their authorized
capacity(), and that byxWWherAWQQr
signature(x) on the instrument the person(m),
or the entity upon behalf of which the
person(g) acted, executed the instrument.
OFFICIALSEA1
SANu, 1,
CALIFOF'wk W:l T N 7m hand 1, official seal.
10TARY PUI Ll�
CONIMISSION iV 230313 y
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SANDEGOCOUNIY
A
My comms msf,,��, C.".",
Az_
SIGNATURE OF NOTARY V
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent
fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER- DESCRIPTION OF ATTACHED DOCUMENT
❑ INDIVIDUAL
❑ CORPORATE OFFICER
TITLE OR TYPE OF DOCUMENT
TITLE(S)
PARTNER(S) F-1 LIMITED
01 GE'NFRAL
❑ ATTORNEY-IN-FACT NUMBER OF PAGES
❑ TRUSTEE(S)
F❑I GUARDIAN/CONSERVATOR
OTHER:
DATE OF DOCUMENT
SIGNER IS REPRESENTING:
NAME OF PePSONS;OR ErRTry(jEs)
SIGNER(S) OTHER THAN NAMED ABOVE
01993 NATIONAL NOTARY ASSOCIATION-8236 Rernmet Ave.,P.O.Box 7184-Canoga Park,CA 91309-7184
POWER FIRST NATIONAL INSURANCE COMPANY OF AMERICA
FIRST /VATIONTAL 4333 BROOKLYN AVE NE
OF ATTORNEY SEATTLE,WASHINGTON 98105
4333 Brooklyn Avenue N.E.
Seattle,WA 98105
No. 4273
KNOW ALL BY THESE PRESENTS:
That FIRST NATIONAL INSURANCE COMPANY OF AMERICA,a Washington corporation,does hereby appoint*
*************J.T.WARNOCK,BART STEWART;CHRISTINE A.PATERSON;LAWRENCE F.MCMAHON;LETICIA SAN MARTIN;San Diego,CaIifonua*************
its true and lawful attomey(s)-in-fact,with full authority to execute on behalf of the company fidelity and surety bonds or undertakings and other documents of a similar
character issued by the company in the course of its business,and to bind FIRST NATIONAL INSURANCE COMPANY OF AMERICA thereby as fully as if such
instruments had been dulyexecuted byits reguiarly elected officersat its home office.
IN WITNESS WHEREOF,FIRST NATIONAL INSURANCE COMPANY OF AMERICA has executed and attested these presents
this 3rd day of Nlay 2001
AM
R.A.PIERSON,SECRETARY MIKE MCGAVICK,PRESIDENT
CERTIFICATE
Extract from the By-Laws of FIRST NATIONAL INSURANCE COMPANY OF AMERICA:
"Article V, Section 13.-FIDELITY AND SURETY BONDS ... the President,any Vice President,the Secretary,and any Assistant Vice President appointed for that
purpose by the officer in charge of surety operations,shall each have authority to appoint individuals as aftomeys-in-factor under other appropriate titles with authority to
execute on behalf of the company fidelity and surety bonds and other documents of similar character issued by the company in the course of its business.-On any
instrument making or evidencing such appointment,the signatures may be affixed by far-simile. On any instrument conferring such authority or on any bond or
undertaking of the company,the seal,or a facsimile thereof,may be impressed or affixed or in any other manner reproduced;provided,however,that the seal shall not
be necessaryto the validity of any such instrument or undertaking,"
Extract from a Resolution ofthe Board of Directors of
FIRST NATIONAL INSURANCE COMPANY OF AMERICA adopted July 28,1970.
"On any certificate executed bythe Secretary or an assistant secretary of the Company setting out,
(i) The provisions of Article V,Section 13 of the By-Laws,and
(ii) A copy of the power-of-aftomeyappointment,executed pursuant thereto,and
(iii) Certifying that said power-of-attomey appointment is in full force and effect,
the signature of the certifying officer may be by facsimile,and the seat of the Company may be a facsimile thereof,"
1, R.A. Pierson, Secretary of FIRST NATIONAL INSURANCE COMPANY OF AMERICA, do hereby certify that the foregoing extracts of the By-Laws and of a
Resolution of the Board of Directors of this corporation,and of a Power of Attorney issued pursuant thereto,are true and correct,and that both the By-Laws,the
Resolution and the Power of Attorney are still in full force and effect.
IN WITNESS WHEREOF,I have hereunto setrny hand and affixed the facsimile seal of said corporation
this 17TH day of JANUARY 2002
Once
Qq,po
SEAL
19 2 a
R.A.PIERSON,SECRETARY
S-11049IFNEF 2!01
513)011 P[1,F
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
County of
LOS ANGELES ss.
On -__ = 4 before me, RAMON C. ARTEAGA 6
Cate Name and Title of Officer(e.g..'Jane Doe,Notary Public") X
personally appeared RAYMOND C. MORALES JR.
Name(s)of Signer(s) -
personally known to me
prayed to me an 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.
WIT S my hand and off' ial se l ,
R f
Place Notary Seal Above Signature of Notary 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 Document
Title or Type of Document:
Document Date:
Number of Pages:
Signer(s)Other Than Named Above:
Capacity(ies) Claimed by Signer
Signer's Name:
Individual • ` ?
Top of thumb dere
Corporate Officer --Title(s): �,ECRETARY m�
El Partner— Limited - General
El Attorney in Fact
Li Trustee
: Guardian or Conservator
Other: i
Signer Is Representing: L A STC CN—A_L— _j_Nr _
J 1997 National Notary Association•9350 De Soft Ave,.PO.Box 2402•Ghaisxonh,CA 31313-2402 Prod.No,�_Wl Reorder.Cali TO'.t-Free 1-800-876-9827
EXECUTED IN TRIPLICATE BOND NO. 5881135
PREMIUM; INCLUDED
PAYMENT BOND
WHEREAS, the City Council of the City of Redlands, State of California (hereinafter designated as
"City"), and--L.A. SIGNAL, INC. (hereinafter designated as "Principal")have entered
into an agreement whereby Principal agrees to install and complVie certain designated public
improvements, which by said agreement dated , 2002, and identified as Contract No.
101302-71501140006, is hereby referred to and made a part hereof; and
WHEREAS, under the terms of said agreement, Principal is required before entering upon the
performance of the work, to furnish a good and sufficient labor and materials payment bond with the City
to secure the claims to which reference is made in Tine 15 (commencing with Section 3082) of Part 4 of
Division 3 of the Civil Code of the State of California.
NOW,THEREFORE, said Principal and the undersigned as corporate surety,are held and firmly bound
unto the City and all contractors, subcontractors, laborers, materialmen, and any other persons employed
in the performance of the aforesaid agreement and referred to in the aforesaid Civil Code of the State of
California in the sum of THIRTY NINE THOUSAND NINE HUNDRED SIXTY dollars
($ 39,960 ) 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 said 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 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 stipulates and agrees that no change, extension of time, alteration or addition to the
terms of the agreement or to the work to be performed thereunder or the specifications accompanying the
same shall in agnosia affect its obligations on this bond, and it does hereby waive notice of any such
change, extension of time, alteration or addition to the terms of the agreement or to the work or to the
specifications.
IN WITNESS WHEREOF, this instrument has been duly executed by the Principal and surety named,
on_ JANUARY 17,__ , 2002. Bond No, 5881135
OF AMERICA
L.A. SIGNAL, INC. (SEAL) FIRST NATIONAL INSURANCE COMPANY (SEAL)
rimcii Suety
6By By:
Signature Signature CHRISTINE A. PATERSON
ATTORNEY—IN—FACT
Address: 2677 N. MAIN STREET
SANTA ANA, CA 92705
(Notarial Acknowledgments of Frincipal and Surety) Telephone: ( 714 ) 437-3043
CD-19
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT � s�
State of California
County of San_nielto
On - before me, America San Martin, Notary Public
DATE NAME.TrR.E OF OFFICER-E.M.'JANE DOE-NOTARY PuN.C- ,
personally appeared CHRISTINE A. PATERSON
NME(s)OF SKW4 (81 '
® personally known to me - OR - ❑ proved to me on the basis of satisfactory evidence
to be the persona) whose name(s) is/=
subscribed to the within instrument and ac-
knowledged to me that3bVshefi2uR executed
the same in his/her/their authorized
capacity(km), and that by MMher
signature(z) on the instrument the persona)
or the entity upon behalf of which the
person(K) acted, executed the instrument.
11 rti's.
-ira .I+- - ;r:. - - F A WrFN S my hand d offs
gra c tial seal
% Xf
% SIGNATURE OF NOTARY
OPTIONAL
Though the data below is not required by law,it may prone valuable to persons relying on the document and could prevent
fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT
❑ INDIVIDUAL
❑ CORPORATE OFFICER
TITLEM TITLE OR TYPE OF DOCUMENT
❑ PARTNER(S) ❑ LIMITED
El GENERAL
❑ ATTORNEY-IN-FACT NUMBER OF PAGES
❑
TRUSTEE(S)
❑ GUARDIAWCONSERVATOR
El OTHER:
DATE OF DOCUMENT
SMER IS RF-PRESENTING:
N"4E OF dEgsON 5,Opt ENTm'eIES-
SIGNERiS4 OTHER THAN NAMED ABOVE
*%993 NAT10NAL NOTARY ASSMA T ION-8236 Ramme!Ave.,P.O.Box"84•Canoga Park,CA 81309-T 194
POWER FIRST NATIONAL INSURANCE COMPANY OF AMERICA
4333 BROOKLYN AVE NE
NATIONAL,`(�U
----------- OF ATTORNEY SEATTLE,WASHINGTON 98105
4333 Brooklyn Avenue N.E.
Seattle,WA 98105 No. 4273
KNOW ALL BY THESE PRESENTS:
That FIRST NATIONAL INSURANCE COMPANY OF AMERICA,a Washington corporation,does hereby appoint
*************J.T.WARNOCK-BART STEWART;CHRISTINE A.PATERSON;LAWRENCE F.MCMAHON:LETICIA SAN MARTIN;San Diego,Califomia******.*.****
its true and lawful attorney(s)4n-fact,with full authority to execute on behalf of the company fidelity and surety bonds or undertakings and other documents of a similar
character issued by the company in the course of its business,and to bind FIRST NATIONAL INSURANCE COMPANY OF AMERICA thereby as fully as if such
instruments had been dulyexecuted byits regularlyelected officersat its home office.
IN WITNESS WHEREOF,FIRST NATIONAL INSURANCE COMPANY OF AMERICA has executed andattested these presents
this 3rd day of May 2001
_&F
R.A.PIERSON,SECRETARY MIKE MCGAVICK,PRESIDENT
CERTIFICATE
Extractfrom the By-Laws of FIRST NATIONAL INSURANCE COMPANY OF AMERICA:
"Article V, Section 13.-FIDELITY AND SURETY BONDS...the President,any Vice President,the Secretary,and any Assistant Vice President appointed for that
purpose by the officer in charge of surety operations,shall each have authority to appoint individuals as aftomeys-in-factor under other appropriate titles with authority to
execute on behalf of the company fidelity and surety bonds and other documents of similar character issued by the company in the course of its business...On any
instrument making or evidencing such appointment,the signatures may be affixed by facsimile. On any instrument conferring such authority or on any bond or
undertaking of the company,the seal,or a facsimile thereof,may be impressed or affixed or in any other manner reproduced;provided,however,that the seal shall not
be necessary to the validity of any such instrument or undertaking."
Extract from a Resolution ofthe Board of Directors of
FIRST NATIONAL INSURANCE COMPANY OF AMERICA adopted July 28,1970.
"On any certificate executed bythe Secretary or an assistant secretary of the Company setting out,
(i) The provisions of Article V,Section 13 of the By-Laws,and
(ii) A copy of the power-of-aftomey appointment,executed pursuant thereto,and
(iii) Certifying that said power-of-aftomey appointment is in full force and effect,
the signature of the certifying officer maybe by facsimile,and the seal of the Company maybe a facsimile thereof."
1, R.A. Pierson, Secretary of FIRST NATIONAL INSURANCE COMPANY OF AMERICA, do hereby certify that the foregoing extracts of the By-Laws and of a
Resolution of the Board of Directors of this corporation,and of a Power of Attorney issued pursuant thereto,are true and correct,and that both the By-Laws,the
Resolution and the Power of Attorney are still in full force and effect.
IN WITNESS WHEREOF,I havehereunto setmy hand and affixed the facsimile seal of said corporation
this 17TH day of JANUARY 2002
SEAL
1928
op
• R.A.PIERSON,SECRETARY
S-1,0491FNEF 2!01
513/01 PDF
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
County of LOS ANGELES ss.
On before me, RAMON C. ARTEAGA
Cate Name and Title of Officer(e.g.,'Jane Doe,Notary Public`)
personally appeared RAYMOND C. MORALES JR.
Name(s)of Signer(s)
personally known to me
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.
WI SS my hand and offici eal.
` e
Place Notary Seal Above Signature of Notary Public
OPTIONAL
Though the information below is not required by law, it may prove valuable to persons retying 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: Number of Pages: h
Signer(s)Other Than Named Above:
Capacity(ies) Claimed by Signer
Signer's Name:
71 Individual I Toc of thurt b here
hCorporate Officer= Titles): PR F'..g,T T)'R Trr/.qFr�x�
Partner—-- Limited General j
Attorney in Fact '
i Trustee I
Guardian or Conservator
71 Other: i
1
Signer Is Representing: L A S TCNAL
✓ _.. to 5 0V 42 % � € 4 y
1997 Nationai.Netary Assc:.iation•9350 De Soto Ave.,P O-Box 2402 Chaisworth.CA 91313-2402 Prod.No,5907 Reorder.Cali Toil--Free 1-800-876-6827