City of Culver City, California
Redevelopment Agency Agenda Item Report
RECOMMENDATION:
Staff recommends the Culver City Redevelopment Agency (the “Agency”) approve a
purchase and sale agreement with the University of California for the purchase of
properties located at 8908, 8910, 8919, and 8921 Lindblade Street.
BACKGROUND:
The properties being recommended for purchase are properties that are no longer
being used by UCLA, but were previously used as a storage facility and book
bindery.
The Agency is interested in purchasing these properties and then subsequently
selling them to Nooshin Malakzad as an effort to further the Agency’s redevelopment
goals. Through the Agency’s acquisition efforts on the triangle site, the Agency
acquired property located at 8831 Exposition Boulevard, owned by Nooshin
Malakzad. Nooshin Malakzad is a fashion designer who has owned her building in
Culver City since 1998. She currently employees 14 people.
Staff recommends purchasing these properties from the University of California and
then subsequently selling them to Nooshin Malakzad as a relocation site for her
business.
DISCUSSION:
The properties in question will suit Nooshin Malakzad as a replacement site and will
even allow her to expand her business. In addition to relocating her office and
Meeting Date: 09/18/06 Item Number: A-1
AGENDA ITEM: Authorization to Enter into a Purchase and Sale Agreement for
properties located at 8908, 8910, 8919, and 8921 Lindblade Street.
Contact Person/Dept.: Alicia Weintraub Phone Number: 310-253-5778
Fiscal Impact: Yes [X] No [] General Fund: Yes [] No [X]
Public Hearing: [] Action Item: [X] Attachments: [X]
Public Notification: Master Notification List (09/13/06), Published in the Culver City
News (08/31/06 & 09/07/06). University of California Real Estate Office and Nooshin
Malakzad (08/31/06).
Department Approval:
Susan Evans (09/06/06)
Exec. Director Approval:
Jerry Fulwood (09/13/06)
City Controller Approval:
Marlee Chang (09/13/06)City of Culver City, California
Redevelopment Agency Agenda Item Report
design studio, she also has plans to open a retail store. These are preferred uses
under the proposed specific plan and further what the Agency is trying to accomplish
in this area.
Nooshin Malakzad’s previous site was approximately 10,000 square feet. The
property that is being recommended for sale is approximately 21,000 square feet.
This site was not recommended as a relocation option for others on the Triangle Site
for the following reasons:
1. Access issues: One property owner requires the use of a semi-truck for
deliveries and a semi-truck cannot turn down Lindblade; and
2. Size: This site did not work for two smaller property owners because of the large
size of this building. Even if the building were subdivided, it would still be too
large.
Upon the close of escrow with UCLA, staff is recommending that the Agency enter
into a short term escrow with Nooshin Malakzad for the sale of the above mentioned
properties.
FISCAL ANALYSIS:
The total purchase price for these properties is $6,525,000. The Agency would not
realize any profit from the sale of these properties, as the purchase price being paid
to UCLA would be the same price that Nooshin Malakzad pays the Agency.
Nooshin Malakzad will pay all costs associated with escrow and legal costs for
drafting and preparing this purchase and sale agreement.
ATTACHMENTS:
3. Purchase and Sale Agreement with the University of California
MOTION:
That the Culver City Redevelopment Agency:
Approve the Execution of a Purchase and Sale Agreement with the University of
California for the sale of properties located at 8908, 8910, 8919, and 8921 Lindblade
Street.
Rev 9/8/2006 1
MEETING DATE: 9/18/06
AGENDA ITEM: Authorization to Enter into a Purchase and Sale Agreement for
properties located at 8908, 8910, 8919 and 8921 Lindblade
Street
ATTACHMENTS
Pages
1) Purchase and Sale Agreement 1-12Rev 9/8/2006 2
PURCHASE AND SALE AGREEMENT
This Purchase and Sale Agreement (the “Agreement”) is entered into this _______ day
of ___________, 2006, by THE REGENTS OF THE UNIVERSITY OF CALIFORNIA, a
California corporation, (“Seller”), and THE CULVER CITY REDEVELOPMENT
AGENCY, a public body, corporate and politic, (“Buyer”).
RECITALS
A. Seller owns all of that real property located at 8908,8910,8919,8921 Lindblade
Street, Culver City, California, more particularly described in Exhibit A attached
hereto and by this reference incorporated herein, together with all improvements
located on such real property, and all easements and rights appurtenant to it (the
“Property”).
B. Seller is willing to sell, and Buyer is willing to buy, the Property on all of the terms
and conditions set forth in this Agreement.
C. It is the intention of the parties that Buyer shall dedicate the Property to public
uses as defined or permitted by California law.
NOW, THEREFORE, for and in consideration of the mutual covenants and conditions
contained herein, the parties agree as follows:
1. Sale and Purchase.
Seller shall sell to Buyer and Buyer shall purchase from Seller all of Seller’s right,
interest and title in and to the Property on the terms and conditions set forth below.
2. Purchase Price.
2.1 Amount. The purchase price (the “Purchase Price”) to be paid by Buyer
for the Property will be Six Million Five Hundred Twenty-five Thousand ($6,525,000).
The Purchase Price shall be paid in cash to Seller in full at Closing.
2.2 Deposit. Buyer shall deposit with Escrow Holder the sum of One Hundred
Thousand Dollars ($100,000.00) (the “Deposit”) no later than five (5) business days
following complete execution of the herein Agreement. Said Deposit shall be non-
refundable to Buyer unless Seller is unable to complete this transaction or the
conditions precedent in Paragraphs 4.1 and 4.3 are not met.
2.3 Liquidated Damages. IF BUYER DEFAULTS UNDER THE TERMS OF
THIS AGREEMENT AND DOES NOT COMPLETE THE TERMS OF THE SALE Rev 9/8/2006 3
WITHIN THE TIME SPECIFIED, TIME BEING OF THE ESSENCE, THE DEPOSIT
SHALL BE RETAINED SUBJECT TO PARAGRAPH 2.2 BY SELLER AS LIQUIDATED
DAMAGES. THE PARTIES AGREE THAT IT IS DIFFICULT TO ASCERTAIN THE
ACTUAL DAMAGES THAT SELLER WILL SUSTAIN IN THE EVENT OF AND BY
REASON OF BUYER’S FAILURE TO COMPLETE THE SALE. ACCORDINGLY, THE
PARTIES AGREE THAT THE AMOUNT OF THE DEPOSIT IS THE BEST
REASONABLE ESTIMATE OF SUCH DAMAGES. THE PARTIES HAVE INITIALED
BELOW TO ESTABLISH THEIR INTENT AS TO LIQUIDATE DAMAGES PURSUANT
TO THE PROVISIONS OF THE CALIFORNIA CIVIL CODE AND THE PARTIES
EXPRESSLY AGREE THAT SUCH LIQUIDATED DAMAGES WILL NOT BE DEEMED
A FORFEITURE OR A PENALTY. UPON SUCH BREACH BY BUYER, BUYER
SHALL HAVE NO FURTHER RIGHTS HEREUNDER. ALL RIGHT, TITLE, AND
INTEREST IN AND TO THE PROPERTY SHALL CONTINUE TO REMAIN VESTED IN
SELLER FREE OF ANY CLAIM OR RIGHT OF BUYER OR THOSE CLAIMING
UNDER BUYER.
ACCEPTED BY: For the Buyer:___________________ For the Seller:_______________
3. Escrow, Closing, Payment of Purchase Price.
3.1 Escrow. Escrow for this transaction will be established with First
American Title Insurance Company, National Commercial Services, 520 N. Central
Avenue, 8
th
floor, Glendale, CA 91203 (the “Escrow Holder”). Escrow shall close and
title to the Property shall transfer within thirty (30) days of full execution of the herein
Agreement or October 31, 2006, whichever last occurs (the “Closing”).
3.2 Deposit of Documents.
3.2.1 Seller shall at or before Closing deposit in escrow:
(a) A grant deed conveying fee simple title to the Property to
Buyer, substantially in the form attached hereto as Exhibit B;
(b) An affidavit stating under penalty of perjury that Seller is not
a foreign person pursuant to the Foreign Investment in Real Property Tax Act of 1980;
(c) All documents and statements of information that may be
reasonably required by the Escrow Holder in order to consummate the sale of the
Property and the Closing; and
(d) Seller’s share of Closing expenses as set forth in Section
3.3, below.
3.2.2 Buyer shall at or before Closing deposit into escrow:Rev 9/8/2006 4
(a) Cash equivalent to the Purchase Price less the amount of
the Deposit;
(b) Buyer’s share of Closing expenses as set forth in Section
3.3, below: and
(c) All documents and statements of information that may be
reasonably required by the Escrow Holder in order to consummate the sale of the
Property and the Closing.
3.2.2 Each party shall execute and deliver to the Escrow Holder written
instructions consistent with the terms hereof and shall provide the Escrow Holder with
such other information, documents, and instruments as the Escrow Holder may
reasonably require to close this transaction.
3.3 Expenses of Closing. Buyer and Seller shall each pay half the cost of title
and escrow charges, including ALTA Owner’s Standard Form title insurance premium,
transfer taxes, escrow fees, and filing and recording fees. If Buyer desires an ALTA
Extended Form title policy, it shall be responsible for the cost of the survey and the
difference in cost between the ALTA Owner’s Standard Form policy and the ALTA
Extended Form policy. Escrow Holder shall debit Seller’s account for its share of the
Expenses of Closing.
3.4 Prorations. Property operating expenses shall be prorated as of close of
escrow.
3.5 Escrow Cancellation Charges. If Escrow should fail to close by reason of
the default of either party hereunder, the defaulting party shall be liable for all Escrow
cancellation charges. If escrow fails to close for any reason other than the default of a
party, each party shall pay one-half (1/2) of all escrow cancellation charges.
4. Conditions Precedent for the Benefit of Seller or Buyer.
4.1 For the Benefit of Both. Seller’s and Buyer’s respective obligations to
close are conditioned on performance of all the other party’s respective obligations
under this Agreement, whether such performance means the performance of an act or
the refraining from performance of an act. Seller’s and Buyer’s respective obligations to
close are further conditioned upon the continuing truth and accuracy of the
representations and warranties set forth in Section 7. herein. Either party may waive in
writing any condition for its benefit. In the event the conditions precedent to the Closing
are not fully satisfied upon the Closing, the party for whose benefit such un-satisfied
condition(s) is for, may terminate this Agreement by providing ten (10) days written
notice to the other party. Except for the foregoing and as provided in Section 4.3,
Buyer’s agreement to buy the Property on the terms of this Agreement is subject to no
other conditions. Rev 9/8/2006 5
4.2 For the Benefit of Seller. This transaction is subject to the approval of the
President of the University of California in conformance with its Standing Orders.
4.3 For the benefit of Buyer. This transaction is subject to and conditioned
upon approval by the governing body of the Agency.
5. Condition of Title. Title to the Property shall be conveyed by Seller to Buyer at
Closing by a grant deed free and clear of all liens, encumbrances, easements,
restrictions, leases, and other matters affecting title, subject only to:
(a) the lien of real property taxes and assessments not then delinquent;
(b) those matters set forth as exceptions shown on the preliminary title report
for the Property dated June 9, 2006, issued by First American Title Insurance
Company, except those exceptions numbered 21-26, inclusive, concerning deeds of
trust securing an indebtedness of Seller;
(c) the standard printed exceptions in a ALTA Owner’s Standard Form policy
of title insurance (the “Permitted Exceptions”);
(d) the reservation of mineral rights by Seller (without the right of surface
entry); and,
Buyer has received a copy of the preliminary title report for the Property.
6. “AS IS” Sale. Except as expressly provided in Article 7, the Property is being
sold “AS IS.” Buyer acknowledges that no representations or warranties of any kind
whatsoever, express or implied, have been made by Seller, its agents, or employees
except as expressly provided herein. Buyer specifically releases Seller, its agents and
employees, from any obligation to investigate the Property or to apprise Buyer of any
conditions that such investigations would reveal. In addition, Buyer acknowledges that
any information provided by Seller, its agents or employees, including, without
limitation, the following: a Phase I report dated June 8, 2006, a summary appraisal
report dated May 25, 2006, a preliminary title report dated June 9, 2006, building plans
for 8921 Lindblade, 5-page internal report dated June 1982 including a mechanical and
structural observational analysis, structural engineering report dated January 1999
performed by Nabih Youssef , and exhaust fan replacement records for 8921 Lindblade
dated August 2000 are provided for information purposes only, and no representation
or warranty is made as to the accuracy or completeness of such information. Buyer
further acknowledges that at Closing, Buyer shall have had every opportunity to inform
itself of and be aware of all zoning regulations, other governmental requirements, site
and physical conditions, including, without limitation, soils conditions, availability and
quality of the water supply, special districts, and other matters affecting the use and
condition of the Property, and agrees to purchase the Property in its “as is” condition at
the close of escrow. In addition, without limiting the generality of the foregoing, Buyer Rev 9/8/2006 6
hereby releases Seller, its officers, agents and employees from any and all claims,
losses, damages, liabilities and penalties which arise from or are connected in any way
with the environmental condition of the Property. In this regard, Buyer expressly waives
any rights or benefits available to it under the provisions of section 1542 of the
California Civil Code, which provides as follows:
“A general release does not extend to claims which the creditor does not
know or suspect to exist in his favor at the time of executing the release,
which if known by him must have materially affected his settlement with
the debtor.”
Seller has no knowledge (i) of the release of any Hazardous Substance in or about the
Property and (ii) of any pending or threatened proceedings or investigations regarding
the presence, release, threat of release, placement, generation, transportation, storage,
treatment or disposal of Hazardous Substances on the Property. “Hazardous
Substance” as used herein means any matter which has been determined by any
existing regulations, order or rule promulgated by a governmental authority of
appropriate jurisdiction, to constitute a hazardous or toxic waste, substance or material
under any federal, state or local statute, law, rule, regulation, ordinance or enactment of
any governmental authority. Buyer acknowledges that by disclosing these matters
above, Seller has complied fully with Section 25359.7 of the California Health and
Safety Code.
7. Representations and Warranties. For the purpose of inducing the other to
enter into this Agreement and to consummate the purchase and sale contemplated
hereby, each party represents and warrants to the other the following representations
and warranties, each of which is material and is being relied upon by the parties:
7.1 Each party represents and warrants to the other that it is duly authorized
to undertake the transactions described herein, except as set forth in 4.3 herein. The
Agreement and all documents executed by such party which shall be delivered to the
other pursuant hereto have been, or will be, duly authorized, executed, and delivered by
such party.
7.2 Seller represents, warrants and covenants to Buyer that:
7.2.1 At Closing, it will deliver possession of the Property free and clear
of all tenancies, occupancies, and rights of possession and there will be no outstanding
leases or occupancy agreements in respect of such property;
7.2.2. It will not cause, suffer, or permit any liens, encumbrances, or other
cloud on the title of the Property from the date hereof to the Closing Date;
7.2.3. It has received no notice of any pending or threatened action or
proceeding arising out of the condition of the Property for alleged violation of
environmental, health, safety, or other statutes, ordinances, or regulations;Rev 9/8/2006 7
7.2.4. To the best of its knowledge there are no actions, suits, material
claims, legal proceedings, or other proceedings affecting the Property before any court
or governmental agency; and
7.2.5 Seller is a California corporation, duly organized and validly existing
and in good standing under the laws of the State of California.
7.3 Buyer represents, warrants and covenants to Seller that:
7.3.1. It is a sophisticated public entity and acknowledges that its
acquisition of the Property is on the basis of its own investigations of all aspects of the
Property. Buyer accepts the Property in an “AS IS” condition except as otherwise
indicated herein and assumes the risk that adverse physical conditions or applicability
and effect of governmental laws and regulations pertaining to materials of
environmental concern may not have been revealed by its own investigations,
examinations, and inspections;
7.3.2. It hereby releases Seller and its officers, employees and agents
from any and all claims for damages, losses, liabilities, costs or expenses whatsoever
(including attorneys’ fees and costs) existing at the time of the Closing or which may
arise in the future on account of or in any way growing out of or connected with the
current presence or previous release of any materials of environmental concern on, in
or about the Property, whether direct or indirect, known, or unknown, foreseen or
unforeseen, except any such liability, claims, losses, damages, costs and expenses,
including attorney’s fees arising out of and resulting from the presence, disposal,
release or threatened release of any materials of environmental concern on, in, about,
beneath or from the Property or other conditions of any sort on, under or about the
Property and the cleanup or remediation of the same which are revealed by its
investigations/examinations, disclosures by the other party, or otherwise prior to the
Closing.
7.3.3. It will dedicate the Property to public use, which includes, but shall
not be limited to the planning, development, or provision of such residential,
commercial, industrial, public, or other structures or land uses as may be appropriate or
necessary in the interest of the general welfare as permitted pursuant to the Community
Redevelopment Law.
8. Disclosures. Seller shall deliver to Buyer, no later than the date of Closing, the
following disclosure forms for the Property:
(a) Natural Hazards Disclosure Statement
(b) Real Estate Transfer Disclosure Statement
(c) Real Estate Agency Disclosure
(d) Mello-Roos Districts disclosure notice
(e) Military Ordnance LocationsRev 9/8/2006 8
(f) Disclosure Regarding Industrial Use
9. Notices. All notices and other communications made pursuant to this
Agreement shall be in writing, may be given by any duly authorized attorney or other
agent on behalf of a party hereto, and shall be deemed properly delivered, given or
served (a) on the same day when personally delivered (including delivery by expedited
courier) or when transmitted by telegraph or telex or (b) forty-eight (48) hours after
being deposited in the United States mail, first class, postage prepaid, to the parties at
the following addresses:
To Buyer: Culver City Redevelopment Agency
9770 Culver Boulevard
Culver City, CA 90232-0507
To Seller: The Regents of the University of California
c/o Real Estate Services Group
1111 Franklin Street, 6th Floor
Oakland, CA 94607-5200
Attn: Director of Real Estate
Either party may change its address for the purposes of this paragraph by giving ten
(10) days prior written notice of change to the other party in the manner provided for in
this paragraph.
10. Time of Essence. Time is of the essence of this Agreement.
11. Attorneys’ Fees. Each party shall pay its own legal fees incurred in connection
with the negotiation of this Agreement and consummation of the transactions
contemplated hereby. If any legal action, arbitration, or other proceeding is
commenced to enforce or interpret any provision of this Agreement, the prevailing party
shall be entitled to an award of its actual expenses, including without limitation, expert
witness fees and attorneys’ fees and disbursements. The term “prevailing party” shall
include a party who receives substantially the relief desired whether by settlement,
dismissal, summary judgment, judgment, or otherwise.
12. Entire Agreement, Conflicts. This Agreement, and each of the Exhibits,
contains the entire agreement of Seller and Buyer with respect to the matters contained
therein and supersedes all prior and contemporaneous arrangements and
understandings between Seller and Buyer, whether oral or in writing, expressed, or
implied.
13. Amendment. This Agreement may only be amended or terminated by an
agreement in writing signed by each of the parties, except as set forth in Section 4
herein.Rev 9/8/2006 9
14. Successors and Assignees. Neither party may assign its rights or duties
herein without the prior written consent of the other party, which consent shall be in
each party’s sole and absolute discretion.
15. Governing Law. This Agreement is being delivered and is to be performed in
the State of California and shall be construed and enforced in accordance with and
governed by the laws of the State of California.
16. Severability. If any provision of this Agreement or any application thereof shall
be invalid or unenforceable, the remainder of this Agreement and any other application
of such provision, to the extent they are not inconsistent with the intent and purpose
hereof, shall not be affected thereby.
17. Counterparts. This Agreement may be executed in counterpart originals, in
which case the counterparts, when fully executed by each of the parties hereto shall
constitute one agreement.
18. Brokers. The parties represent and warrant that neither party has incurred any
obligations for real estate commissions, finder’s fees or any similar fees in connection
with the transaction contemplated herein. If any other person asserts a claim for
commission or finder’s fees in connection with this transaction based upon contact or
dealings with Buyer or Seller, the party through whom that person makes his claim will
indemnify, hold harmless, and defend that other party form such claim and all expenses
including reasonable attorney’s fees, incurred by the other party in defending the claim.
[Signatures on following page]Rev 9/8/2006 10
IN WITNESS WHEREOF, the parties have executed this Purchase and Sale
Agreement as of the day and year first written above.
SELLER:
THE REGENTS OF THE UNIVERSITY OF CALIFORNIA
By: _______________________________
Its: _______________________________
Date: _______________________________
BUYER:
CULVER CITY REDEVELOPMENT AGENCY
By: _______________________________
Its: _______________________________
Date: _______________________________Rev 9/8/2006 11
EXHIBIT A
Description of Property
Real property in the City of Culver City, County of Los Angeles, State of California, described as
follows:
PARCEL 1:
Lots 28, 29, 30, 31, 32, 33, 35 and 36 of Tract No. 4161, in the City of Culver City, as per map
recorded in Book 46 Page 32 of Maps, in the Office of the County Recorder of said County.
EXCEPT that portion of Lot 36 described as follows:
Beginning at the corner of said Lot 36 which is common to Lots 37, 54 and 55 of said Tract No.
4161, as said Lots are shown on the Record of Survey filed in Book 147 Page 26 of Records of
Survey, in the Office of said County Recorder; thence along the Southwesterly line of said Lot 36
North 52º 40' 45" West, 0.51 feet to the center of the eight (8) inch wide (0.67') block wall, (the
location of said Wall being determined by field measurements on September 30, 1996); thence,
along the center of said Wall North 47º 30' 42" East, 41.12 feet; thence, continuing along the
center of said Wall South 71º 20' 42" East, 3.14 feet to the intersection of said Center of Wall
with the Southeasterly line of Lot 36, said Point of Intersection being located South 50º 20' 29"
West, 0.25 feet along said Southeasterly line from the corner of said Lot 36 common to Lots 35,
55, and 56 of said Tract No. 4161; thence, along said Southeasterly line South 50º 20' 29" East,
45.60 feet to the point of beginning.
PARCEL 2:
Parcel 13, in the City of Culver City, as per record of Survey Map, filed in Book 81 Page 95 of
Records of Survey, in the Office of the County Recorder of said County.
EXCEPT therefrom that portion described as follows:
Beginning at the most Northerly corner of said Parcel 13; thence South 28º 48' 01" West, 243.74
feet to the most Southerly corner of said Parcel 13; thence Northeasterly and Northwesterly,
along the Southeasterly and Northeasterly boundaries of said Parcel 13 to the point of beginning.
ALSO EXCEPT from the remainder thereof that portion lying Northeasterly of the Southeasterly
prolongation of that certain course in the boundary of said Parcel shown on said map as North
35º 41' 00" West 110.00 feet.
ALSO EXCEPT therefrom all the minerals, oil, gas, and other hydrocarbon substances, below a
depth of 500 feet from the surface of said land but without any right to enter upon or disturb the
ground within 500 feet of the surface thereof, dated March 4, 1963, as granted to Janus Oil
Company, a partnership, in Deed recorded April 19, 1963 in Book D-1998 Page 819, Official
Records.
APN: 4206-015-901 and 4206-016-900 and 4206-013-903 and 4206-016-902Rev 9/8/2006 12
EXHIBIT B
Form of Grant Deed
AND WHEN RECORDED MAIL THIS DEED AND, UNLESS OTHERWISE
SHOWN BELOW, MAIL TAX STATEMENT TO:
TITLE ORDER NO.
GRANT DEED
APN SPACE ABOVE THIS LINE FOR RECORDER'S USE
No Recording Fee pursuant to Government Code 6103
FOR VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, THE REGENTS OF
THE UNIVERSITY OF CALIFORNIA, a California public corporation
(“GRANTOR”), hereby GRANTS to (“GRANTEE”), that certain real
property known as , in the City of
State of California, and more particularly described as:
Legal Description or (“Exhibit A attached and by this referenced incorporated
herewith”), subject to all matters of record.
A reservation to Seller, its successors and assigns of the mineral interest and not as a
royalty interest, all oil, gas, other minerals and hydrocarbon substances, and accompanying fluids
including, but not by way of limitation, all geothermal resources in, under, or produced and saved from
the real property granted thereby, together with any of the forgoing which may be allocated thereto
pursuant to any pooling or utilization agreement or ratable takings program to which Seller my
subscribe, and together with the sole and exclusive right to prospect for, drill for, produce, and remove
such oil, gas, other minerals and hydrocarbon substances and geothermal resources, from the Property
below the depth of five hundred feet (500') from the surface of said real property, without the right of
surface entry, but including the right to slant drill from adjacent property, the right to utilize subsurface
storage for natural substances, and the right to maintain subsurface pressures.
GRANTOR:
THE REGENTS OF THE UNIVERSITY OF CALIFORNIA,
a California public corporation
By:
Its:
Dated:
\MAIL TAX STATEMENTS AS DIRECTED ABOVERev 9/8/2006 13
State of
County of
On before me
personally appeared
personally known to me (or 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.
WITNESS my hand and official seal.
Signature (seal)