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HomeMy WebLinkAboutSeaside Heating & Air Conditioning Inc; 2015-04-27; PWM15-77PEMPWM15-77PEM CITY OF CARLSBAD MINOR PUBUC WORKS CONTRACT SENIOR CENTER HVAC REPLACEMENT CONTRACT NO. 47111 This agreement is made on the ^7 day of /f/J/^/ / , 2015, by the City of Carlsbad, California, a municipal corporation, (hereinaftef called "City"), and Seaside Heating & Air Conditioning, Inc., a Califomia corporation, whose principal place of business is 2942 Industry St. #A Oceanside CA 92054 (hereinafter called "Contractor"). City and Contractor agree as follows: DESCRIPTION OF WORK. Contractor shall perform all work specified in the Contract documents for the project described by these Contract Documents (hereinafter called "Project"). PROVISIONS OF LABOR AND MATERIALS. Contractor shall provide all labor, materials, tools, equipment, and personnel to perform the work specified by the Contract Documents unless excepted elsewhere in this Contract. CONTRACT DOCUMENTS. The Contract Documents consist of this Contract, exhibits to this Contract, Contractor's Proposal, the Plans and Specifications, the General Provisions, addendum(s) to said Plans and Specifications, and all proper amendments and changes made thereto in accordance with this Contract or the Plans and Specifications, all of which are incorporated herein by this reference. When in conflict, this Contract will supersede terms and conditions in the Contractor's proposal. LABOR. Contractor will employ only skilled workers and abide by all State laws and City of Carisbad Ordinances governing labor. GUARANTEE. Contractor guarantees all labor and materials furnished and agrees to complete the Project in accordance with directions and subject to inspection approval and acceptance by: Bob Richardson (City Project Manager). WAGE RATES. The general prevailing rate of wages for each craft or type of worker needed to execute the contract shall be those as determined by the Director of Industrial Relations pursuant to Sections 1770, 1773 and 1773.1 of the Labor Code. Pursuant to Section 1773.2 of the Labor Code, a current copy of the applicable wage rates is on file in the Office of the City Engineer. The contractor to whom the contract is awarded shall not pay less than the said specified prevailing rates of wages to all woricers employed by him or her in execution of the contract. The Prime Contractor shall be responsible for insuring compliance with provisions of section 1777.5 of the Labor Code and section 4100 et seq. ofthe Public Contracts Code, "Subletting and Subcontracting Fair Practices Act." The City Engineer is the City's "duly authorized officer" for the purposes of section 4107 and 4107.5. The provisions of Part 7, Chapter 1, of the Labor Code commencing with section 1720 shall apply to the Contract for work. A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, unless currently registered and qualified to perform public work pursuant to Section 1725.5. This project is subject to compliance monitoring and enforcement by the Department of Industrial Relations. SENIOR CENTER HVAC REPLACEMENT Page 1 of 8 City Attorney Approved 3/6/15 CONTRACT NO. 47111 PWM15-77PEM FALSE CLAIMS. Contractor hereby agrees that any contract claim submitted to the City must be asserted as part of the contract process as set forth in this agreement and not in anticipation of litigation or in conjunction with litigation. Contractor acknowledges that California Government Code sections 12650 et seq., the False Claims Act, provides for civil penalties where a person knowingly submits a false claim to a public entity. These provisions include false claims made with deliberate ignorance of the false information or in reckless disregard of the truth or falsity of the information. The provisions of Carisbad Municipal Code sections 3.32.025, 3.32.026, 3.32.027 and 3.32.028 pertaining to false claims are incorporated herein by reference. Contractor hereby acknowledges that the filing of a false claim may subject the Contractor to an administrative debarment proceeding wherein the contractor may be prevented from further bidding on public contracts for a period of up to five years and that debannent by another jurisdiction is grounds for the City of Carisbad to disqualify the Contractor or subcontractor from participating in contract bidding. Signature: ( ^ Print Name: ^/tf-/-^'-s. So^/'c^^ f— REQUIRED INSURANCE. The successful contractor shall provide to the City of Carisbad, a Certification of Commercial General Liability and Property Damage Insurance and a Certificate of Workers' Compensation Insurance indicating coverage in a form approved by the California Insurance Commission. The certificates shall indicate coverage during the period of the contract and must be furnished to the City prior to the start of work. The minimum limits of liability insurance are to be placed with insurers that have: (1) a rating in the most recent Best's Key Rating Guide of at least A-:V and (2) are admitted and authorized to transact the business of insurance in the State of Califomia by the Insurance Commissioner. Commercial General Liability Insurance of Injuries including accidental death, to any one person in an amount not less than $1,000,000 Subject to the same limit for each person on account of one accident in an amount not less than $1,000,000 Property damage insurance in an amount of not less than $1,000,000 Automobile Liability Insurance in the amount of $1,000,000 combined single limit per accident for bodily injury and property damage. In addition, the auto policy must cover any vehicle used in the perfomiance of the contract, used onsite or offsite, whether owned, non-owned or hired, and whether scheduled or non- scheduled. The automobile insurance certificate must state the coverage is for "any auto" and cannot be limited in any manner. The above policies shall have non-cancellation clauses providing that thirty (30) days written notice shall be given to the City prior to such cancellation. The policies shall name the City of Carisbad as an additional insured. WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY. Workers' Compensation limits as required by the California Labor Code. Workers' Compensation will not be required if Contractor has no employees and provides, to City's satisfaction, a declaration stating this. INDEMNITY. The Contractor shall assume the defense of, pay all expenses of defense, and indemnify and hold harmless the City, and its officers and employees, from all claims, loss, damage, injury and liability of every kind, nature and description, directly or indirectly arising from or in connection witli the performance of the Contract or work; or from any failure or alleged failure of Contractor to comply with any applicable law, ailes or regulations including those related to safety and health; and from any and all claims, loss, damages, injury and liability, howsoever the same may be caused, resulting directly or indirectly from the SENIOR CENTER HVAC REPLACEMENT Page 2 of 8 City Attorney Approved 3/6/15 CONTRACTNO. 47111 PWM15-77PEM nature of the work covered by the Contract, except for loss or damage caused by the sole or active negligence or willful misconduct of the City. The expenses of defense include all costs and expenses including attorneys' fees for litigation, arbitration, or other dispute resolution method. JURISDICTION. The Contractor agrees and hereby stipulates that the proper venue and jurisdiction for resolution of any disputes between the parties arising out of this agreement is San Diego County, Califomia. Start Wori<: Contractor agrees to start within 5 working days after receipt of Notice to Proceed. Completion: Contractor agrees to complete work within 30 working days after receipt of Notice to Proceed. CONTRACTOR'S INFORMATION. SEASIDE HEATING & AIR CONDITIONING 2942 INDUSTRY ST. #A (name of Contractor) (street address) 790514 OCEANS IDE CA 92054 (Contractor's license number) (city/state/zip) C20, C38, C4 / Exp. 1-31-17 760-643-1100 (license class, and exp. date) (telephone no.) 760-433-3904 (fax no.) cb@seasidehvac.com (e-mail address) /// /// /// /// /// /// /// /// /// /// /// /// /// /// /// SENIOR CENTER HVAC REPLACEMENT Page 3 of 8 City Attorney Approved 3/6/15 CONTRACTNO. 47111 PWM15-77PEM AUTHORITY. The individuals executing this Agreement and the instruments referenced in it on behalf of Contractor each represent and warrant that they have the legal power, right and actual authority to bind Contractor to the terms and conditions of this Agreement. CONTRACTOR SEASIDE HEATING & AIR CONDITIONING, a Califomia corporation CITY OF CARLSBAD, a municipal corporation of the State of Califomia ^i::r^I?Slgn here) Jimmie Sebring / President Patrick A. Thomas, Public Works Director as authorized by the City Manager By: (print name/title) (sign here) Charles Balcar / CFO (print name/title) If required by City, proper notarial acknowledgment of execution by Contractor must be attached. If a corporation. Agreement must be signed by one corporate officer from each of the following two groups: Group A Chairman, President, or Vice-President Group B Secretary, Assistant Secretary, CFO or Assistant Treasurer otherwise, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering the officer(s) signing to bind the corporation. APPROVED AS TO FORM: CELIA A. BREWER, City Attomey BY: Assistant City Attorney SENIOR CENTER HVAC REPLACEMENT Page 4 of 8 CONTRACT NO. 47111 City Attorney Approved 3/6/15 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 On I iia ) Ok JCTS?^^ CO q^\^Sh3(^d^^ Date ^ HepB^lnsart Name and Trtjgjffthe Offjc^f^ V) Name(s) of Signerfs) c personally appeared 1 vY>vr>Vg^ .si5~of who proved to me on the basiT^f satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instalment 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. 1 OFFICIAL SEAL JACINDA M. AVALOS » NOTARY PUBLIG-CALIFORNlAi COMM. NO. 2094946 ^ SAN DIEGO COUNTY MY COMM. EXP. DEC. 25,2018 J WITNESS Signature nd and official seal. ignature of Notary Public Place Notary Seal Above OPTIONAL Thougti this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this fomn to an unintended document. Description of Attached Document Title or Type of Document: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Document Date: • Corporate Officer — Title(s): • Partner — • Limited • General • Individual • Attorney in Fact • Trustee • Guardian or Conservator • Other: Signer Is Representing: Signer's Name: • Corporate Officer — Title(s): • Partner — • Limited • General • Individual • Attorney in Fact • Trustee • Guardian or Conservator • Other: Signer Is Representing: ©2014 National Notary Association • www.NationalNotary.org • 1 -800-US NOTARY (1 -800-876-6827) Item #5907 PWM15-77PEM EXHIBIT A LISTING OF SUBCONTRACTORS BY GENERAL CONTRACTOR Set forth below is the full name and location of the place of business of each sub-contractor whom the Contractor proposes to subcontract portions of the Project in excess of one-half of one percent of the total bid, and the portion of the Project which will be done by each sub-contractor for each subcontract. NOTE: The Contractor understands that if it fails to specify a sub-contractor for any portion of the Project to be performed under the contract in excess of one-half of one percent of the bid, the contractor shall be deemed to have agreed to perfonn such portion, and that the Contractor shall not be permitted to sublet or subcontract that portion ofthe work, except in cases of public emergency or necessity, and then only after a finding, reduced in writing as a public record of the Awarding Authority, setting forth the facts constituting the emergency or necessity in accordance with the provisions of the Subletting and Subcontracting Fair Practices Act (Section 4100 et seq. of the California Public Contract Code). If no subcontractors are to be employed on the project, enter the word "NONE." SUBCONTRACTORS Portion of Project to be Subcontracted Business Name and Address License No., Classification & Expiration Date %of Total Contract l^c^^<^c<^< 99~^'/o Total % Subcontracted: SENIOR CENTER HVAC REPLACEMENT Page 5 of 8 CONTRACTNO. 47111 City Attorney Approved 3/6/15 PWM15-77PEM EXHIBIT B Description: Replace 15 ton heat pump at the City of Carisbad Senior Center as part of CIP project #3707000-9060/ 47111-9066 Scope of Work: Provide all labor, materials, and equipment to replace existing 15 ton Rooftop package heat pump with new Carrier Model #50TCQD17A2A50A0G0 with condenser coil coating, curb adapter, and factory economizer. Contractor also includes disposal of the existing unit the price. Contractor will include any Titie 24 Compliance. JOB QUOTATION NO. mm ^vr 1 EA 1 Senior Center HVAC Replacement - Carrier Model #50TCQD17A2A50A0G0 with condenser coil coating, curiD adapter, and factory economizer $26,160 TOTAL* $26,160 *lncludes taxes, fee's, expenses and all other costs. SENIOR CENTER HVAC REPLACEMENT Page 6 of 8 CONTRACTNO. 47111 City Attorney Approved 3/6/15 BOND: 803205P PREMIUM: $653.00 PWM15-77PEM PREMIUM IS FOR CONTRACT TERM AND IS SUBJECT TO ADJUSTMENT EXHIBIT C BASED ON FINAL CONTRACT PRICE. LABOR AND MATERIALS BOND WHEREAS, the City of Carisbad, State of Califomia, has administratively awarded to Seaside Heating & Air Conditioning (hereinafter designated as the "Principal"), a Contract for: SENIOR CENTER HVAC REPLACEMENT CONTRACT NO. 47111 in the City of Carisbad, in strict conformity with the drawings and specifications, and other Contract Documents now on file in ttie Office of the City Clerk of the City of Carisbad and all of which are incorporated herein by this reference. WHEREAS, Principal has executed or is about to execute said Contract and the tenms thereof require the fumishing of a bond, providing tiiat if Principal or any of its subcontractors shall fail to pay for any materials, provisions, provender or ottier supplies or teams used in, upon or about the perfonnance of the wori< agreed to be done, or for any wori< or labor done thereon of any kind, the Surety on this bond will pay the same to the extent hereinafter set forth. NOW. THEREFORE, WE, SEASIDE HEATING & AIR CONDITIONING, as Principal, (hereinafter designated as tfie "Contractor"), and INDEMNITY COMPANY OF CALIFORNIA as Surety, are held fimily bound unto the City of Carisbad in the sum of Twenty Six Thousand One Hundred Sixty Dollars ($26,160), said sum being an amount equal to: One hundred percent (100%) of ttie total amount payable under the terms of ttie Contract by the City of Carisbad, and for which payment well and truly to be made we bind ourselves, our heirs, executors and administrators, successors, or assigns, jointty and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH tiiat if the Contractor or his/her subcontractors fail to pay for any materials, provisions, provender, supplies, or teams used in, upon, for, or about ttie performance of the work contracted to be done, or for any other work or labor thereon of any kind, consistent with California Civil Code section 9100, or for amounts due under the Unemployment Insurance Code with respect to the work or labor performed under tiiis Contract, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from tiie wages of employees of the contractor and subcontractors pursuant to section 13020 of the Unemployment Insurance Code with respect to the wort< and labor, that the Surety will pay for the same, and, also, in case suit is brought upon the bond, reasonable attorney's fees, to be fixed by the court consistent with Califomia Civil Code section 9554. This bond shall inure to the benefit of any of the persons named in Califomia Civil Code section 9100, so as to give a right of action to those persons or their assigns In any suit brought upon the bond. Surety stipulates and agrees that no change, extension of time, alteration or addition to the ternis of the Contract, or to the work to be performed hereunder or the specifications accompanying the same shall affect its obligations on this bond, and it does hereby waive notice of any change, extension of time, alterations or addition to the terms of the contract or to the work or to the specifications. SENIOR CENTER HVAC REPLACEMENT Page 7 of 8 City Attomey Approved 3/6/15 CONTRACT NO. 47111 PWM15-77PEM In the event that Contractor is an individual, it is agreed that the death of any such Contractor shall not exonerate the Surety from its obligations under this bond. Executed by CONTRACTOR this. of /Irp? i' 1 ( .20_jJ»'' CONTRACTOR: SEASIDE HEATING AND AIR CONDITIONING day Executed by SURETY this, of APRIL 2ND .day ,20 15 . (name of Contractor) By: SURETY: INDEMNITY COMPANY OF CALIFORNIA (name of Surety) 17771 COWAN STE 100 IRVINE CA 92614 {sign here) (address of Surety) i/^t^ > -e ^ -g r-' '*-<^ T^''^ 800-782-1546 (print name here) ' (signature of Attorney-in-Fact) TED COLLINS, ATTORNEY IN FACT (printed name of Attorney-in-Fact) (attach corporate resolution showing current power of attorney) (title and organization of signatory) Bv: (^^ 7^ . r j^c} (sign here) (print name here) (title and organization of signatory) (Proper notarial acknowledgment of execution by CONTRACTOR and SURETY must be attached.) (President or vice-president and secretary or assistant secretary must sign for corporations. If only one officer signs, the corporation must attach a resolution certified by the secretary or assistant secretary under corporate seal empowering that officer to bind the corporation.) APPROVED AS TO FORM: CELIA A. BREWER stant City Attorney \ SENIOR CENTER HVAC REPLACEMENT Page 8 of 8 CONTRACT NO. 47111 City Attorney Approved 3/6/15 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 SAN DIEGO On APRIL 2. 2015 Dafe personally appeared _ before me, TED COLLINS A. WATT, NOTARY PUBLIC Here Insert Name and Title of the Officer Name(s) of Signer(s) 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(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. Cofwniwion # 1^192149 Hot«r» t'uWic - C|ltforii»» S«n Diiflo Countsi I certify under PENALTY OF PERJURY underthe laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official a Signature A. WATT Signature hf-Pntary Public Place Notary Seal Above OPTIONAL Though this section is optional, 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: Number of Pages: Signer(s) Other Than Named Above; Capacity(ies) Claimed by Signer(s) Signer's Name: Docunnent Date: • Corporate Officer — Title(s): • Partner — • Limited • General • Individual • Attorney in Fact • Trustee • Guardian or Conservator • Other: Signer Is Representing: Signer's Name: • Corporate Officer — Title(s): • Partner — • Limited • General • Individual • Attorney in Fact • Trustee • Guardian or Conservator • Other: Signer Is Representing: ©2014 National Notary Association • www.NationalNotary.org • 1 -800-US NOTARY (1 -800-876-6827) Item #5907 POWER OF ATTORNEY FOR DEVELOPERS SURETY AND INDEMNITY COMPANY INDEMNITY COMPANY OF CALIFORNIA PO Box 19725, IRVINE, CA 92623 (949) 263-3300 KNOW ALL BY THESE PRESENTS that except as expressly limited, DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, do each hereby make, constitute and appoint: ***Ted Collins, Leslie Hahn, A. Watt, Steven R. Bonllla, jointly or severally*** as their true and lawful Attomey(s)-in-Fact, to make, execute, deliver and acknowledge, for and on behalf of said corporations, as sureties, bonds, undertakings and contracts of suretyship giving and granting unto said Attomey(s)-ln-Fact full power and authority to do and to perform every act necessary, requisite or proper to be done in connection therewith as each of said corporations could do, but reserving to each of said corporations full power of substitution and revocation, and all of the acts of said Attorney(s)-in-Fact, pursuant to these presents, are hereby ratified and confirmed. This Power of Attorney is granted and is signed by facsimile under and by authority of the following resolutions adopted by the respective Boards of Directors of DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA, effective as of January 1st 2008. RESOLVED, that a combination of any two of the Chairman of the Board, the President, Executive Vice-President, Senior Vice-President or any Vice President of the corporations be, and that each of them hereby is, authorized to execute this Power of Attorney, qualifying the attomey(s) named in the Power of Attorney to execute, on behalf of the corporations, bonds, undertakings and contracts of suretyship; and that the Secretary or any Assistant Secretary of either of the corporations be, and each of them hereby is, authorized to attest ttie execution of any such Power of Attorney; RESOLVED, FURTHER, ttiat the signatures of such officers may be affixed to any such Power of Attomey or to any certificate relating ttiereto by facsimile, and any such Power of Attomey or certificate bearing such facsimile signatures shall be valid and binding upon the corporations when so affixed and in ttie fuUire witti respect to any bond, undertaking or contract of suretyship to which il Is attached. IN WITNESS WHEREOF DEVELOPERS SURETY AND INDEMNITY COMPANY and INDEMNITY COMPANY OF CALIFORNIA have severally caused ttiese presents to be signed by their respective officers and attested by ttieir respective Secretary or Assistant Secretary this January 29,2015. By; Daniel Young, Senior Vice-President Marie Lansdon, Vice-President *'J.':'H.\ f^/^ OCT. if ! 10 O z /§! Y>J\ 1936 'ii*0 v^j." 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 Califomia County of Orange On Januan>29, 2015 . before me. personally appeared LUCILLE RAYMOND Commission # 2061945 Notary PuMic • California Orange County ^ My Comm. Expires Oct 13,20181 Place Notary Seal Above Lucille Raymond, Notary Public Here Insert Name and Title ofthe Officer Daniel Young and Marie Lansdon Name(s) of Stgner[s) who proved to me on ttie basis of satisfectory evidence to be ttie person(s) whose name(s) is/are subscribed to ttie wittiin insfrument and acknowledged to me ttiat he/she/they executed the same in his/her/ttieir auttiorized capacity(ies), and ttiat by his/her/ttieir signature(s) on ttie insfrument ttie person(s), or the entity upon behalf of which the person(s) acted, executed ttie insfrument I certify under PENALTY OF PERJURY under the laws of ttie State of Califomia ttiat the foregoing paragraph is true and correct. WITNESS my hand and official seal Signatijre CERTIFICATE The undersigned, as Seaetary or Assistant Seaetary of DEVELOPERS SURETY AND INDEMNITY COMPANY or INDEMNITY COMPANY OF CALIFORNIA, does hereby certify tiiat ttie foregoing Power of Attomey remains in full force and has not been revoked and, furtfiemiore, ttiat the provisions of Hie resolutions of ttie respective Boards of Directors of said corporations set fortti in the Power of Attomey are in force as of ttie date of this Certificate. This Certificate is executed in the City of Irvine, Califomia, ttiis 2nd day of APRIL , 2015 ID-1380(Rev01/15) 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 Califomia Dafe Here Insert Name and Title of the Officer, J personally appeared Name(s) of Signer(s) to 1tl€ 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(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. 1 OFRCIALSEAL JACINDA M. AVALOS NOTARY PUBUC-CALIFORNlAg COMM. NO. 2094946 ^ SAN DIEGO COUNTY • MY COMM. EXP. DEC. 25,2018 | WITNESS my hand and official seal Signature Place Notary Seal Above OPTIONAL Though this section is optional, 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: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name: Document Date: • Corporate Officer — Title(s): • Partner — • Limited • General • Individual • Attomey in Fact • Trustee • Guardian or Conservator • Other: Signer Is Representing: Signer's Name: • Corporate Officer — Title(s): • Partner — • Limited • General • Individual • Attomey in Fact • Trustee • Guardian or Conservator • Other: Signer Is Representing: ©2014 National Notary Association • www.NationalNotary.org • 1 -800-US NOTARY (1 -800-876-6827) Item #5907