HomeMy WebLinkAboutContracts & Agreements_230-2024PUBLIC WORK CONSTRUCTION CONTRACT
This Public Work Construction contract ("Contract") is made and entered into this 17th day of December,
2024, by and between the City of Redlands, a municipal corporation, organized and existing under the
laws of the State of California (hereinafter "City"), and MCC Pipeline, Inc. (hereinafter "Contractor").
City and Contractor are sometimes individually referred to herein as a "Party" and, together, as the
"Parties."
In consideration of the mutual promises contained herein, City and Contractor agree as follows:
SCOPE OF WORK: Contractor shall furnish all materials and will perform all of the work for the
following: 2023 CIP Water Pipeline and Highline Replacement Project, complete all items as
required by the Contract Documents (as herein defined) and Specifications for City's 2023 CIP
Water Pipeline and Highline Replacement Project, Project No. 501063 (the "Work").
2. CONTRACT SUM: City shall pay Contractor the sum of Twelve Million Fifty -Eight Thousand
Three Hundred Sixty -Two Dollars and Ninety -Nine Cents ($12,058,362.99) as consideration for its
performance of the Work in accordance with the terms and conditions set forth in the Contract
Documents. Pursuant to Public Contract Code Section 22300, Contractor has the option to deposit
securities with an escrow agent as a substitute for retention of earnings required to be withheld by
City pursuant to an escrow agreement as set forth in Public Contract Code section 22300.
3. TIME FOR COMPLETION: The Work shall be completed within one hundred eighty (180)
working day(s) as defined in Section 1-2 of the Standard Specifications for Public Works
Construction "Greenbook" from and after the date of City's issuance of a Notice to Proceed to
Contractor.
4. LIQUIDATED DAMAGES: Contractor's failure to complete the Work within the time allowed
will result in damages being sustained by City. Such damages are, and will continue to be,
impracticable and extremely difficult to determine. Accordingly, Contractor shall pay to City, or
have withheld from monies due to Contractor, the sum of five hundred dollars ($500) for each
working day as defined in Section 1-2 of the Standard Specifications for Public Works Construction
"Greenbook" in excess of the specified time for completion of the Work. Execution of this Contract
shall constitute agreement by City and Contractor that five hundred dollars ($500) per day is the
estimated damage to City caused by the failure of Contractor to complete the work within the
allowed time. Such sum is liquidated damages and shall not be construed as a penalty, and may be
deducted from payments due Contractor if such delay occurs.
5. CONTRACT DOCUMENTS: This Contract incorporates by reference the following: Notice
Inviting Bids, Instructions to Bidders, Contractor's Proposal, Bid Bond, Agreement, Performance
Bond, Labor and Material Bond, Plans, General Conditions, Special Provisions and Specifications,
and any addenda thereto (collectively, the "Contract Documents").
6. ATTORNEYS' FEES: In the event any action is commenced to enforce or interpret the terms or
conditions of this Contract, or the Contract Documents, the prevailing Party in such action, in
addition to any costs and other relief, shall be entitled to recover its reasonable attorneys' fees,
including fees for use of in-house counsel by a Parry.
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7. RESOLUTION OF CONSTRUCTION CLAIMS: Claims by Contractor in the amount of three
hundred seventy five thousand dollars ($375,000) or less shall be made by Contractor and processed
by the City pursuant to the provisions of Part 3, Chapter 1, Article 1.5 of the Public Contract Code
(commencing with Section 20104). All claims shall be in writing and include the documents
necessary to substantiate the claim. Nothing in subdivision (a) of Public Contract Code Section
20104.2 shall extend the time limit or supersede the notice requirements provided in this case from
filing claims by Contractor.
8. ELIGIBILITY OF CONTRACTOR/SUBCONTRACTOR: Contractor and all of its
subcontractors shall abide by California Public Contract Code, Section 6109, and California Labor
Code Sections 1777.1 and/or 1777.7, and certify that they are not debarred and are eligible to work
on this project.
9. ASSIGNMENT OF AGREEMENT: No assignment by a Party of any rights or interests under
this Contract shall be binding on another Party without the written consent of the Party sought to be
bound.
10. SUCCESSORS AND ASSIGNS: City and Contractor each binds itself and their respective
successors and assigns in respect to all covenants, agreements, and obligations contained in the
Contract Documents.
11. SEVERABILITY: Any provision or part of the Contract Documents held to be void or
unenforceable under any law or regulation shall be deemed stricken, and all remaining provisions
shall continue to be valid and binding upon City and Contractor.
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IN WITNESS WHEREOF, the Parties hereto have executed this Contract the day and year first written
above.
(SEAL)
ATTEST:
ne Donaldson, City Clerk
CITY OF REDLANDS
By.�—�- / —'— L
��-��� � Major
(SEAL)
MCC Pipeline, Inc.
Name of Contractor
B
ignature of Authorized Agent
reSi aexi+
Title
71-S
Si gi atuureof-Authorized Age (if necessary)
�
Title
993?-q9
Contractor's License No.
LlemolAgreements\MCC Pipeline, Inc. Public Work Contract (2023 CIP Water Pipeline Replacement Project) FY24-0075.doex-ms
WORKER'S COMPENSATION INSURANCE CERTIFICATION
Description of Contract: City of Redlands
Municipal Utilities and Engineering Department
2023 CIP Water Pipeline and Highline Replacement Project
Project No. 501063
Every employer, except the State, shall secure the payment of compensation in one or more of the
following ways:
a. By being insured against liability to pay compensation by one or more insurers duly
authorized to write compensation insurance in this State.
b. By securing from the Director of Industrial Relations, a certificate of consent to self -
insure, either as an individual employer, or as one employer in a group of employers,
which may be given upon furnishing proof satisfactory to the Director of Industrial
Relations of ability to self -insure and to pay any compensation that may become due
to his or her employees.
CHECK ONE
I am aware of the provisions of Section 3700 of the Labor Code which requires every employer
to be insured against liability for Workers' Compensation or to undertake self-insurance in
accordance with the provisions of that Code, and I will comply with such provisions before
commencing the performance of the work and activities required or permitted under this Agreement.
(Labor Code §1861).
I affirm that at all times, in performing the work and activities required or permitted under this
Agreement, I shall not employ any person in any manner such that I become subject to the workers'
compensation laws of California. However, at any time, if I employ any person such that I become
subject to the workers' compensation laws of California, immediately I shall provide the City with a
certificate of consent to self -insure, or a certification of workers' compensation insurance.
I certify under penalty of perjury under the laws of the State of California that the information and
representations made in this certificate are true and correct.
Dated this I / day of ae66m�2024.
MCC Pipeline, Inc.
(Co, ti 2ctor)
G�
(Signature)
prijeGy-' lwep(Aogei
(Official Title)
(SEAL)
(Labor Code Section 1861 provides that the above certificate must be signed and filed by the Contractor with the
Owner prior to performing the work of the contract.)
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TFIEFINAG,PREMIUM IS This bond was issued in two (2) original counterparts
F'RE66ATE®(3N THE
Bond No. GM243826
FINAL CONTRAGTAMOUNT- Premium: $79,073.00
FAITHFUL PERFORMANCE BOND
Whereas, the City of Redlands ("City"), State of California, and MCC Pipeline, Inc.
(hereinafter designated as 'Principal') have entered into an agreement dated December 17, 2024
("Agreement") whereby Principal agrees to install and complete certain public improvements (the
"Wort,"), which said Agreement is identified as 2023 CIP Water Pipeline and Highline Replacement
Project, Project No. 501063 and is hereby referred to and made a part hereof, and
Whereas, said Principal is required under the terms of the Agreement to furnish a bond for the
faithful performance of the Work, now, therefore, we, the Principal and,
Great Midwest Insurance Company , as Surety, are held and firmly bound unto the City in the penal
sum of Twelve Million Fifty -Eight Thousand Three Hundred Sixty -Two Dollars and Ninety -Nine Cents
($12,058,362.99) lawful money of the United States, for the payment of which sum we bind ourselves,
and 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 its 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 Agreement and any alteration
thereof made as therein provided, on his or its 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
faithfully fulfill the one-year guarantee of all materials and workmanship, and shall defend,
indemnify and save harmless the City and 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 to the face amount specified therefor,
there shall be included costs and reasonable expenses and fees, including reasonable attorneys' fees,
incurred by the City in successfully enforcing such obligations, all to be taxed as costs and included
in the judgment rendered.
As a condition precedent to the satisfactory completion of the Work, the above obligation
shall hold good for a period of one (1) year or longer if required by the Agreement after the acceptance
of the work by the City, during which time if the Principal shall fail to make full, complete, and
satisfactory repair and replacements and totally protect the City from loss or damage made evident
during this period from the date of completion of the Work, and resulting from or caused by defective
materials or faulty workmanship, the above obligation in penal sum thereof shall remain in full force
and effect. The obligations of Surety hereunder shall continue so long as any obligation of the
Principal remains.
Whenever the Principal shall be, and is declared by the City to be, in default under the
Agreement, the City having performed the City obligations thereunder, the Surety shall promptly
remedy the default, or shall promptly, at the City's option:
1. Complete the Work in accordance with its terms and conditions; or
2. Obtain a bid or bids for completing the Work in accordance with its terms and
conditions, and upon determination by Surety of the lowest responsive and responsible bidder,
arrange for a contract between such bidder and the City, and make available as work progresses
sufficient funds to pay the cost of completion of the Work less the balance of the Agreement price,
IAcmolAgreemcnts\MCC Pipeline, Inc. Public Work Contract (2023 Cn' Water Pipeline Replacement Project) FY24-0075.doex-ins
but not exceeding, including other costs and damages for which Surety may be liable hereunder, the
amount set forth above. The term "balance of the Agreement price," as used in this paragraph, shall
mean the total amount payable to the Principal by the City under the Agreement and any modifications
thereto, less the amount previously properly paid by the City to the Principal.
Surety expressly agrees that the City may reject any contractor or subcontractor which may
be proposed by Surety in fulfillment of its obligations in the event of default by the Principal.
Surety shall not utilize the Principal in completing the Work nor shall Surety accept a bid from
the Principal for completion of the Worm if the City, when declaring the Principal in default, notifies
Surety of the City's objection to the Principal's further participation in the completion of the Work.
No right of action shall accrue on the bond to or for the use of any person or corporation other
than the City named herein or the successors or assigns of the City. Any suit under this bond must
be instituted within the applicable statute of limitations period.
The said Surety, for value received, 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 any way 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.
No final settlement between the City and the Principal shall abridge the right of any
beneficiary hereunder whose claim may be unsatisfied.
The Principal and Surety agree that if the City is required to engage the services of any
attorney in connection with the enforcement of this bond, each shall pay the City's reasonable
attorneys' fees incurred, with or without suit, in addition to the above sum.
In witness whereof, this instrument has been duly executed by the Principal and Surety above
named, on December 5th , 2024.
(SEAL)
MCC Pipeline, Inc.
_ 1 Contr ct }
(Signature)
(Seal and Notarial Acknowledgment of
Surety)
(SEAL)
Gre t e suranc om n
Sur }
BY:
(Signature) haunna Rozelle Ostroni,
Attorney -in -Fact
Address: 25622 Orchard Rim lane
Lake Forest, GA 92630
Telephone ( 949 )W4-3836
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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 . Orange )
On 12/05/2024
before me, Melissa Ann Vaccaro, Notary Public _
(insert name and title of the officer)
personally appeared Shaunna Rozelle Ostrom
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 helshelthey 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.
WITNESS my hand and official seal. MELISSAANNVACCAR0
ComNi. #2401942 r
Notary Pubiic-California a
* a ' ;tip ORANGE CQUNi'Y k
My Comm. Expires May 12, 2026
Signature�� U� � (Seat)
Melissa Ann Vaccaro
Bond No. GM243826
POWER OF ATTORNEY
Great Midwest Insurance Company
KNOW ALL MEN BY THESE PRESENTS, that GREAT MIDWEST INSURANCE COMPANY, a Texas Corporation, with its principal off
in Houston, TX, does hereby constitute and appoint:
Arturo Ayala, Daniel Huckabay, Dwight Reilly, Shaunna Rozelle Ostrom, Frank Morones, Michael D. Stong, Ben Stong, R. Nappi,
Benjamin Wolfe, Chelsea Liberatore, Adrian Langrell
its true and lawful Attorneys) -In -Fact to make, execute, seal and deliver for, and on its behalf as surety, any and all bonds, undertakings or oil
writings obligatory In nature of a bond.
This authority is made under and by the authority of a resolution which was passed by the Board of Directors of GREAT
NICE COMPANY, on the 13' day of October, 2018 as follows:
Resolved, that the President, or any officer, be and hereby Is, authorized to appoint and empower any representative of the Company
person or persons as Attorney -In -Fact to execute on behalf of the Company any bonds, undertakings, policies, contracts of Indemnity or oth
gs obligatory in nature of a bond not to exceed Twenty -Five Million dollars ($25,000,000.00), which the Company might execute through i
:Iected officers, and affix the seal of the Company thereto. Any said execution of such documents by an Attorney -In -Fact shall be as bindir
the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company. Any Attorney -In -Fact,
mad, may be removed in the Company's sole discretion and the authority so granted may be revoked as specified in the Power of Attorney.
Resolved, that the signature of the President and the seal of the Company may be affixed by facsimile on any power of attorney gram
the signature of the Secretary, and the seal of the Company may be affixed by facsimile to any certificate of any such power and any s
ar or certificate bearing such facsimile signature and seal shall be valid and binding on the Company. Any such power so executed and see
certificate so executed and sealed shall, with respect to any bond of undertaking to which it is attached, continue to be valid and binding on
IN WITNESS THEREOF, GREAT MIDWEST INSURANCE COMPANY, has caused this instrument to be signed by its President, and
Seal to be affixed this 111h day of February, 2021.
d4��t lNBuq,�,d�
C0hP0AATn SFAL g.
Aa00npov,-
ACKNOWLEDGEMENT
GREAT MIDWEST INSURANCE COMPANY
BY 041 0 1
Mark W. Haushill
President
On this 11th day of February, 2021, before me, personally came Mark W. Haushill to me known, who being duly sworn, did depose and
that he is the President of GREAT MIDWEST INSURANCE COMPANY, the corporation described in and which executed the above instrument;
he executed said instrument on behalf of the corporation by authority of his office under the By-laws of said corporation.
, 01113, INA 0ICNOP
�Nbisfy Puldto, Slow of taxes BY
s Comm.Iii 0444-3'1128 Christina Bishop
r.. NbtefY{D 19109048$ Notary Public
CERTIFICATE
1, the undersigned, Secretary of GREAT MIDWEST INSURANCE COMPANY, A Texas Insurance Company, DO HEREBY CE
original Power of Attorney of which the foregoing is a true and correct copy, is in full force and effect and has not been revoked and the
set forth are now in force. -
and Sealed at Houston, TX this Sth Day of December 2024
511NSUggNC�
o
CORPOBAM SPAL BY
Leslie K.
sfi p' Secri
0OnP01iP
:: Any person who knowingly and with intent to defraud any insurance company or other person, flies and application for Insurance of dial
any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits
Insurance act, which is a crime and subjects such person to criminal and civil penalties.
THE FINAL PREMIUM 15
This bond was issued in two (2) original counterparts
PREDICATED ON THE Bond No. GM243826
FINAL CONTRACT AMOUNT
LABOR AND MATERIAL BOND
Whereas, the City Council of the City of Redlands, State of California, and MCC Pipeline, Inc.
(hereinafter designated as "Principal") have entered into an agreement (the "Agreement") whereby Principal
agrees to install and complete certain designated public improvements (the "Work"), which said agreement,
dated December 17, 2024, and identified as 2023 CIP Water Pipeline and Highline Replacement Project,
Project No. 501063 is hereby referred to and made a part hereof, and
Whereas, under the terms of the Agreement, Principal is required before commencing the performance
of the Work, to file a good and sufficient Labor and Material bond with the City of Redlands to secure the
claims to which reference is made in Title 3 (commencing with Section 9550) of Part 6 of Division 4 of the
Civil Code of the State of California,
Now, therefore, said Principal and the undersigned as corporate surety, are held firmly bound unto the
City and all contractors, subcontractors, laborers, material men and other persons employed in the performance
of the Agreement and referred to in the aforesaid Code of Civil Procedure in the sum of Twelve Million Fifty -
Eight Thousand Three Hundred Sixty -Two Dollars and Ninety -Nine Cents ($12,058,362.99) 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 attorneys' 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 judgment therein rendered.
It is hereby expressly stipulated and agreed that this bond shall insure to the benefit of any and all
persons, companies and corporations entitled to file claims under Title 3 (commencing with Section 9550) of
Part 6 of Division 4 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 the specifications accompanying the same shall in any manner affect its obligations
on this bond, and it does hereby waive notice of any such change, extension of time, alteration or addition.
In witness whereof, this instrument has been duly executed by the Principal and surety above named,
on December 5th , 2024.
(SEAL)
MCC Pipeline, Inc.
(Con or)
(Signature
iScal and Notarial Acknowledgement of Surety)
(SEAL)
Great I4Ai'd+�restAnsurance Comoan
BY: /=
(Signature) 5naunna I?ozelle Ostrom,
Attorney-in-�:c,:t
Address: 25622 Orchard Rim Lane
Lake Forest, CA 92630
Telephone: ( 949 ) 804-3836
7
hcmo\AgrecmcntslMCC Pipeline, Inc. Public Work Contract (2023 CIP Water Pipeline Replacement Project) FY24-0075.doex-ms
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 Orange )
On 12/05/2024
before me, _ Melissa Ann Vaccaro, Notary Public _
(insert name and title of the officer)
personally appeared Shaunna Rozelle Ostrom
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 helshelthey executed the same in
hislherltheir 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.
WITNESS my hand and official seal. MEusso aruNvaccaRa
m COMM.#2401942
N = .c
Notary Public -California Nv)
J / ORANGE COUNTY 9
* i41y Comm. Expires May 12, 202G�(
Signature `. f7CC{�r,�� (Seal)
Melissa Ann Vaccaro
Bond No. GM243826
POWER OF ATTORNEY
Great Midwest Insurance Company
KNOW ALL MEN BY THESE PRESENTS, that GREAT MIDWEST INSURANCE COMPANY, a Texas Corporation, with its principal off
n Houston, TX, does hereby constitute and appoint:
Arturo Ayala, Daniel Huckabay, Dwight Reilly, Shaunna Rozelle Ostrom, Frank Marches, Michael D. Stong, Ben Stang, R. Nappi,
Benjamin Wolfe, Chelsea Liberatore, Adrian Langrell
is true and lawful Attorney(s)-In-Fact to make, execute, seal and deliver for, and on its behalf as surety, any and all bonds, undertakings or of
Nritings obligatory in nature of a bond.
This authority is made under and by the authority of a resolution which was passed by the Board of Directors of GREAT
VCE COMPANY, on the 1 sr day of October, 2018 as follows:
Resolved, that the President, or any officer, be and hereby is, authorized to appoint and empower any representative of the Company o
person or persons as Attorney -In -Fact to execute on behalf of the Company any bonds, undertakings, policies, contracts of indemnity or othe
gs obligatory in nature of a bond not to exceed Twenty -Five Million dollars ($25,000,000.00), which the Company might execute through it
elected officers, and affix the seal of the Company thereto. Any said execution of such documents by an Attomey-In-Fact shall be as binding
the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company. Any Attomey-In-Fact, si
nted, may be removed in the Company's sole discretion and the authority so granted may be revoked as specified in the Power of Attorney. -
Resolved, that the signature of the President and the seal of the Company may be affixed by facsimile on any power of attorney grani
the signature of the Secretary, and the seal of the Company may be affixed by facsimile to any certificate of any such power and any s
or or certificate bearing such facsimile signature and seal shall be valid and binding on the Company. Any such power so executed and see
certificate so executed and sealed shall, with respect to any bond of undertaking to which it is attached, continue to be valid and binding on
IN WITNESS THEREOF, GREAT MIDWEST INSURANCE COMPANY, has caused this instrument to be signed by its President, and
e Seal to be affixed this 11th day of February, 2021.
��5x IN9 C
rr
OOAPORATESE4
AS bOaPOR�4�
ACKNOWLEDGEMENT
GREAT MIDWEST INSURANCE COMPANY
BY 04 0
Mark W. Haushill
President
On this 11th day of February, 2021, before me, personally came Mark W. Haushill to me known, who being duly sworn, did depose and
that he Is the President of GREAT MIDWEST INSURANCE COMPANY, the corporation described in and which executed the above instrument;
he executed said instrument on behalf of the corporation by authority of his office under the By-laws of said corporation.
' ...�+i. -cHnISTdNrj BL8N0
Notary Publ(s, Statb of 7r;xAq - BY
=Comrl Expftag 44 s-ly& Christina Bishop
rf NntBfY.db `J314804BS Notary Public
. CERTIFICATE
I, the undersigned, Secretary of GREAT MIDWEST INSURANCE COMPANY, A Texas Insurance Company, DO HEREBY CE
original Power of Attorney of which the foregoing is a true and correct copy, is in full force and effect and has not been revoked and the
set forth are now in force.
and Sealed at Houston, TX this 5th
�����t lNdupghc�e
IFr
CORPORATESEAL
a
,'rR3poflPORP�O
Day of December , 2024
BY
Leslie K.
Any person who knowingly and with Intent to defraud any insurance company or other person, files and application for insurance of clai
any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits
insurance act, which is a crime and subjects such person to criminal and civil penalties.
CALIFORNIA ACKNOWLEDGMENT
CIVIL CODE § 1189
A notary public or other officer completing this certificate verifies onlythe 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�1
County of �[�,1Yl�aYl�lYl(`� J}
On DCro e)( �) , j7J� before me, C,( rn)e, �e, NCM( _ N _YV ?U)?�G,
Date Here insert Name and Title of the Officer
r
personally appeared 1
NameA of SignerK
who proved to me on the basis of satisfactory evidence to be the person(x whose name O
is K subscribed
to the within instrument and acknowledged to me that IA she they executed the same in her th-jr
authorized capacity(iVO, and that by HOChel tl*ir signature , on the instrument the person($(, or the entity
upon behalf of which the person acte executed the instrument.
CAMIE LEE mARTINEZ
Notary P ;blic - California
Orange County
Z Commission ° 2378090
My Comm, Expires Oct 10, 2025
Place Notary Seal and/or Stomp 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
Signature of Notary�ublie� .r
Completing this information can deter alteration of the document or
fraudulent reattachment of this form to an unintended 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):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer is Representing:
02019 National Notary Association
Number of Pages:
Signer's Name:
❑ Corporate Officer -- Title(s):
❑ Partner — ❑ Limited C] General
❑ Individual n Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer is Representing:
CALIFORNIA 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 1
County of V1_[�Yi _e, ,Y&YY7 J}
On Cf>.YYI�Xk1)'%fl�� before me, LOirYyi e,_v_.0ftMf7_ NU''�" V�
Date Here Insert Name and Title of the Officer
personally appeared Dana d \e 'NV)1n07_-
Nomek of Signer`}
who proved to me on the basis of satisfactory evidence to be the person.(4whose name is subscribed
to the within instrument and acknowledged to me that ee t*y executed the same in er/ it
authorized capacity(iX), and that by herl Xr signature on the instrument the person(, r the entity
upon behalf of which the personXacte , executed the instrument.
CAMIE LEE MARTINEZ
Notary Public -California
Orange County
Cornmission a 2378090
My Comm, Expires Oct 10, 2025
Place Notary Seal ondlor Stamp 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.
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❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
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02019 National Notary Association
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Signer's Name:
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer is Representing: