HomeMy WebLinkAbout1999-11-16; City Council; 15496; Lease Agreement Colonial Mall For Adult LearningAB# 15,496
MTG. 1 l/16/99
DEPT. PW/GS
- d #-c- &O 3
CITY OF CARLSBAD -AGENDA BILL
TITLE: DEPT. H
APPROVE-LEASE AGREEMENT WITH COLONIAL MALL FOR ADULT LEARNING CENTER % CITY Al-W.
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RECOMMENDED ACTION:
Adopt Resolution No. 99-499 authorizing the Mayor to execute the lease
agreement between the City of Carlsbad and Colonial Mall.
ITEM EXPLANATION:
Since 1990, the City has been leasing space from Colonial Mall (1207 Catlsbad
Village Drive) to operate its Adult Learning Center. The current lease has expired
and staff feels it is necessary to execute a new lease agreement until the Adult
Learning Center is moved to the portable modules at City Hall.
Staff has negotiated a new three (3) year lease agreement with Colonial Mall. A key
provision to the new lease agreement is that staff was successful in negotiating a
reduction in the termination clause from 180 days to 90 days. The new rental rate
charged to the City in the first year is $1,829 per month, an increase of 3.5%. A
new lease agreement has been prepared and is attached hereto as Exhibit 2. The
new lease has been reviewed and approved as to form by the City Attorney’s office.
FISCAL IMPACT:
The new lease agreement will increase the City’s rent for the Adult Learning Center
to $1,829 a month, or $21,948 annually. The rent for year two is increased to $1,897
a month and year three to $1,966 a month. Funds are included in the Community
Services Department for this purpose.
EXHIBITS:
1. Resolution No. gg-4gg authorizing the Mayor to execute the lease
agreement between the City of Carlsbad and Colonial Mall.
2. Lease Agreement
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RESOLUTION NO. w-499
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF CARLSBAD, CALIFORNIA, APPROVING A LEASE AGREEMENT WITH COLONIAL
MALL FOR SPACE NO. M, N, 0 AND T LOCATED AT 1207 CARLSBAD
VILLAGE DRIVE, CARLSBAD CALIFORNIA
WHEREAS, the City of Carlsbad, California has determined the need to provide office
space for the Adult Learning Center; and
WHEREAS, staff has negotiated with the property manager and secured a new three-
year lease with rent in year one of $1,829, year two of $1,897 and year three of $1,966.
NOW, THEREFORE, BE IT RESOLVED, BY THE City Council of the City of Carlsbad as
follows:
1. That the above recitations are true and correct.
2. That the new Lease Agreement between the City of Carlsbad and Colonial Mall
attached hereto as Exhibit 2 is hereby approved.
3. That the Mayor is hereby authorized to sign the lease agreement on behalf of the
. City.
PASSED, APPROVED AND ADOPTED by the City Council of the City of Carlsbad at its
regular meeting held on the 16th day of November , 1999, by the following vote, to wit:
AYES: Lewis, Hall, Finnila, Nygarrd, Kulchin
ATTEST:
Karen R. Kundtz, Assistant City Clerk (SEAL)
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Exhibit No. 2
COLONIAL MALL
LEASE TO
City of Carlsbad
OF PROPERTY LOCATED AT
1207 Carlsbad Village Drive
Carlsbad, CALIFORNIA
FOR 3 YEARS
COMMENCING ++ 9
AND ENDING ++3.
1.
2.
3.
4.
5.
6.
7.
a.
9.
10.
11.
12.
DESCRIPTION.. ......................................................................................................................... 1
TERM ......................................................................................................................................... 1
RENT .......................................................................................................................................... 1
USE.. ........................................................................................................................................... 1
TERMINATION ......................................................................................................................... 1
IMPROVEMENTS ..................................................................................................................... 1
LIENS ......................................................................................................................................... 2
ASSIGNMENT-SUBLEASE .................................................................................................... .2
DEFAULT ................................................................................................................................. 2
SUPERSEDURE.. ....................................................................................................................... 2
MAINTENANCE AND REPAIR .............................................................................................. 3
UTILITIES .................................................................................................................................. 3
13. CONFORMANCE WITH RULES AND REGULATIONS ..................................................... .3
14. PARTIAL INVALIDITY .......................................................................................................... .3
15. HOLD HARMLESS ................................................................................................................... .
16. SUCCESSORS IN INTEREST .................................................................................................. 3
17. INSURANCE .............................................................................................................................. 3
18. DAMAGE TO OR DESTRUCTION OF PREMISES .............................................................. .4
19. CONTROL OF OFF-STREET PARKING. ............................................................................... .5
20. SIGNS ......................................................................................................................................... 5
2 1. PEACEABLE S URRENDER.. ................................................................................................... 5
22. WAIVER .................................................................................................................................... 5
23. HOLD OVER.. ............................................................................................................................ 6
24. SECTION HEADINGS .............................................................................................................. .
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25. ENTIRE UNDERSTANDING .................................................................................................. .6
26. NOTICES.. ................................................................................................................................. .6
27. REMOVALS OF MATERIALS ................................................................................................. 6
28. ACCEPTANCE OF PREMISES ................................................................................................ 7
29. QUIET POSSESSION.. ............................................................................................................. .7
30. ABSTRACT OF LEASE ............................................................................................................ 7
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. . . III
LEASE AGREEMENT
THIS LEASE AGREEMENT, made and entered into this L dd3fid day of NWembcr’ J999,
by and between the Colonial Mall, hereinafter called “Lessor”, and City of Carlsbad, hereinafter called
“Lessee”.
1. DESCRIPTION: Lessor hereby leases to Lessee and Lessee hires from Lessor, on the terms and
conditions hereinafter set forth, Space No. M, N, 0 and T of 1207 Carlsbad Village Drive (Colonial
Mall), County of San Diego, State of California, consisting of approximately 1,359 square feet, together
with the non-exclusive right to use the adjacent paved off-street parking area.
2. TERM: The term of the lease shall be for a period of 3 years commencing on I 1-2 3 ,1999,
and ending on /I - a A ,2002 unless sooner terminated as herein provided. Upon the expiration of this
lease, the Lessee shall have the option to extend the term for two (2) additional one (1) year periods,
upon the same terms and conditions stated herein. Lessee must exercise this option in writing at least
120 days prior to the lease terms expiration.
3. RENT:
(a) As and for the rent, Lessee agrees to pay to Lessor the sum of one thousand eight hundred
twenty-nine dollars ($1,829) per month, payable in advance on or before the first day of each
and every month during the term of this Agreement.
(b) In the event Lessee is delinquent in remitting the rent due in accordance with the rent
provisions of this lease, then the rent not paid when due shall pay Lessor a late charge equal
to 10% of such overdue amount.
(c) Commencing on the anniversary date of this lease in years two (2) and three (3) said monthly
rent shall increase as follows if the lease is still in effect:
Year 2: One thousand eight hundred ninety-seven dollars ($1,897) per month.
Year 3: One thousand nine hundred sixty-six dollars ($1,966) per month.
(d) If Lessee exercises its option to extend the term of this lease, the monthly rent for the new
term shall be determined and agreed upon by the parties hereto.
4. USE: Lessee shall use the leased property for the purpose of conducting any City of Carlsbad
business together with any incidental business in furtherance thereof. Lessee agree not to commit, or
suffer to be committed, any waste upon the leased property or any nuisances in or upon any part of
the leased property.
5. TERMINATION: LESSOR AND LESSEE SHALL EACH have the right to terminate this lease
by first giving ninety (90) days prior written notice to the other party.
6. IMPROVEMENTS: Lessee shall not make, or suffer to be made, any alterations of the leased
property, or any part thereof, without the written consent of Lessor had and obtained. Unless Lessor
requires their removal, all alterations, improvements, additions, including draperies, which may be
made on the Premises, shall become the property of Lessor and remain upon and be surrendered with
the Premises at the expiration of the term.
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7. LIENS: Lessee agrees that it will at all times save Lessor free and harmless and indemnify it
against all claims for labor or materials in connection with improvements, repairs, or alterations on
the lease premises, and the costs of defending against such claims, including reasonable attorney’s
fees.
8. ASSIGNMENT-SUBLEASE: Lessee shall not assign or transfer the whole or any part of this
lease or any interest therein, nor sublease the whole or any part of the leased premises, nor contract
for the management or operation of the whole or any part of the leased premises, nor permit the
occupancy of any part thereof by any other person, nor permit transfer of the lease of possession of
the leased premises by merger, consolidation or dissolution, nor permit sale of a controlling interest
in the voting stock in said corporation without the consent of Lessor.
No assignment, voluntary or involuntary, in whole or in part of the lease or any interest therein, and
no sublease of the whole or any part of the leased premises, and no contract for the management or
operation of the whole or any part of the leased premises, and no permission to any person to occupy
the whole or without the consent of Lessor, first had and obtained in each instance; provided,
however, that nothing herein contained shall be construed to prevent the occupancy of said premises
by any employee or business invitee of Lessee.
9. DEFAULT: Should default be made in the payment of any of the rent to be paid hereunder and
such default continue for a period of ten (10) days after written notice from Lessor to Lessee, or
should default be made in the performance or observance of any other condition or covenant herein
required to be performed or observed by Lessee, and such default continue for a period of thirty (30)
days after written notice from Lessor to Lessee specifying such default, then in any such event and in
addition to any and all other rights or remedies of Lessor hereunder and/or by law provided, it shall
be lawful for Lessor, at sole option of Lessor, to declare the term hereof ended and to reenter the
leased property and take possession thereof and remove all persons therefrom and Lessee shall have
no further claim thereon or hereunder; provided, however, that if the default complained of (money
payment excepted) is of such a nature that the same cannot be rectified within the period allowed for
curing such default, then such default shall be deemed to be rectified if Lessee shall have
commenced within such period to comply with the provisions hereof which have been breached by
it, and if Lessee shall, with all diligence, proceed to rectify such default; or Lessor, at option of
Lessor, and without declaring this lease ended, may re-enter the leased property and lease the whole
or any part thereof for and on account of Lessee for a term greater or lesser than the remaining
balance of the leased term, and on such other terms and conditions and for such reasonable rent as
Lessor may deem proper, and may collect said rent or any other rent that may thereafter become
payable and apply the same toward the amount due or thereafter to become due from Lessee and on
account of the reasonable expenses of such subletting incurred by Lessor. Should such rental be less
than that herein agreed to be paid by Lessee, Lessee agrees to pay such deficiency to Lessor and to
pay to Lessor, forthwith upon any such reletting, the costs and expenses Lessor may incur by reason
thereof.
10. SUPERSEDURE: This lease upon becoming effective shall supersede and annul any and all,
leases or rental agreements heretofore made or issued for the leased premises between Lessor and
Lessee, and any such, leases or rental agreements shall hereafter be void and of no effect except as to any
rentals and/or fees which may have accrued thereunder or any rights and remedies granted to Lessor
under such agreements.
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11. MAINTENANCE AND REPAIR: As part of the consideration for the leasing thereof, Lessee
agrees to assume full responsibility for the interior operation, maintenance, including painting, and repair
of the premises, throughout the term and without expense to the Lessor. Lessee will perform all interior
maintenance, repairs and replacements, including glass, necessary to maintain and preserve the premises
in a good, safe, healthy and sanitary condition satisfactory to Lessor and in compliance with all
applicable laws. Lessor shall be responsible for all exterior maintenance, including roof repairs, outside
portion of the exterior walls, and structural portion of the building. Lessor shall also be responsible for
all maintenance and repair to the off-street parking lot and the landscaping.
12. UTILITIES: Lessor agrees to pay all charges for water, refuse removal, ground and building
maintenance, parking lot maintenance and landscaping. Lessee agrees to pay all charges for gas,
electricity, telephone, cleaning and maintenance of the inside of the leased property and any other
commodities, conveniences or services used by Lessee, in, upon or about the leased property during the
tm of the lease.
13. CONFORMANCE WITH RULES AND REGULATIONS: Lessee agrees that in all activities on
or in connection with the leased premises and in all uses thereof, including the making of any alterations
or changes and the installation of any machines other improvements, it will abide by and conform to all
ordinances, rules and regulations prescribed by the City of Carlsbad, including the Building Code, and
any applicable laws of the State of California and Federal Government, as any of the same now exist or
may hereafter be adopted or amended.
14. PARTIAL INVALIDITY: If any term, covenant, condition, or provision of this lease is held by
a court of competent jurisdiction to be invalid, void or unenforceable, the remainder of the provisions
hereof shall remain in full force and effect and shall in no way be affected, impaired, or invalidated
thereby.
15. HOLD HARMLESS: Lessee shall indemnify, and hold harmless Lessor, its officers and
employees against causes of action, liability, damage, and expense, including reasonable attorney’s fees,
for judicial relief of any kind, for damage to property of any kind whatsoever and to whomever
belonging, including without limitation Lessee or its employees, or injury or death of any person or
persons, including without limitation Lessee or its employees, resulting directly the use and operation of
the leased premises by lessee.
16. SUCCESSORS IN INTEREST: Unless otherwise provided in this lease, the terms, covenants
and conditions herein shall apply to and bind the heirs, successors, executors, administrators, and assigns
of all the parties hereto, all of whom shall be jointly and severally liable hereunder.
17. INSURANCE: Lessee shall maintain insurance acceptable to Lessor in full force and effect
throughout the term of this lease. The policies for said insurance shall, as a minimum, provide the
following forms of coverage:
A. Comprehensive General Lrabilitv (covering premises and operations) in the amount of
not less than Five Hundred Thousand Dollars ($500,000) combined single limit. This
policy shall cover any injury or damage, including death, suffered by any party, for any
act, committed by anyone, including Lessor.
B. Property Insurance - Lessee agrees to provide coverage for tenant improvements,
betterments and personal property. Lessor will be responsible for providing coverage for
the structure itself, exclusive of the items required to be covered by lessee’s insurance
policy.
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C. Evidence of Insurance - Certificates in a form acceptable to Lessor evidencing the
existence of the necessary insurance policies shall be kept on file with Lessor during the
entire term of this lease. All insurance companies providing coverage pursuant to this
agreement must meet Lessor minimum standards and be licensed to do business in
California.
Lessor shall retain the right at any time to review the coverage, form, and amount of the
insurance required hereby. If, in the opinion of the Lessor, the insurance provisions in
this lease do not provide adequate protection for Lessor and/or for members of the public
using the leased premises, Lessor may require Lessee to obtain an insurance sufIlcient in
coverage, form and amount to provide adequate protection. Lessor’s requirements shall
be reasonable but shall be designed to assure protection from and against the kind and
extent of risk which exist at the time a change in insurance is required.
Lessor shall notify Lessee in writing of changes in the insurance requirements and, if
Lessee does not deposit certificates evidencing acceptable insurance policies with Lessor
incorporating such changes within sixty (60) days of receipt of such notice, this lease
shall be in default without further notice to Lessee, and Lessor shall be entitled to all
legal remedies.
The procuring of such policies of insurance shall not be construed to limit Lessee’s
liability hereunder, not to fulfil1 the indemnification provisions and requirements of this
lease. Notwithstanding said policies of insurance, Lessee shall be obligated for the full
and total amount of any damage, injury, or loss caused by negligence or neglect
connected with this lease or with the use or occupancy of the leased premises.
Lessee agrees not to use the premises in any manner, even if use is for purposes stated
herein, that will result in the cancellation of any insurance Lessor may have on the
premises or on adjacent premises, or that will cause cancellation of any other insurance
coverage for the premises or adjoining premises. Lessee further agrees not to keep on
the premises or permit to be kept, used, or sold thereon, anything prohibited by any fire
or other insurance policy covering the premises. Lessee shall, at its sole cost and
expense, comply with any and all requirements, in regard to premises, of any insurance
organization necessary for maintaining fire and other insurance coverage at reasonable
cost.
18. DAMAGE TO OR DESTRUCTION OF PREMISES: In the event of any partial destruction of
the said leased property during the said terms, from any cause, Lessor shall forthwith repair the same,
provided such repairs can be made within ninety (90) working days under the laws and regulations of
State, Federal, County or City of Carlsbad authorities, but such partial destruction shall in no way annul
or void this lease, except the Lessee shall be entitled to a proportionate deduction to be based upon the
extent to which the making of such repairs shall interfere with the business carried on by Lessee in the
said leased property. If the repairs cannot be made in ninety (90) working days, Lessor may, at his
option, make same within a reasonable time, this lease continuing to be in full force and effect and the
rent to be proportionately rebated as aforesaid in this paragraph provided. In the event the Lessor does
not elect to make such repairs which cannot be made in ninety (90) working days, or such repairs cannot
be made under such laws and regulations, this lease may be terminated at the option of either party.
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In respect to any partial destruction which Lessor is obligated to repair or may elect to repair
under the terms of this paragraph, the provisions of Section 1932.2 and Section 1933.4 of the Civil Code
of the State of California, are waived by Lessee. The pertinent sections, above referred to, of the Civil
Code of the State of California read as follows:
Section 1932. The hirer of a thing may terminate the hiring before the end of the term agreed
upon.
(2) When the greater part of the thing hired, or that part which the letter had at the time of the
hiring reason to believe was the material inducement to the hirer to enter into the contract,
perishes from any other cause than the want of ordinary care of the hire.
Section 1933. The hiring of a thing terminates:
(4) By the destruction of the thing hired.
In the event that the building in which the leased property may be situated be destroyed to the
extent of not less that 33 l/3 percent of the replacement cost thereof, Lessor may elect to terminate this
lease, whether the leased property be injured or not. A total destruction of the building in which the said
leased property may be situated shall terminate this lease.
19. CONTROL OF OFF-STREET PARKING: In reference to the off-street parking, Lessor shall
have the right to adopt rules and regulations for the use of the off-street parking by Lessee and shall have
the right to designate specified parking areas for Lessee, employee of Lessee and the general public.
Any non-compliance with said rules and regulations or said designated parking areas shall constitute a
breach of this lease by Lessee.
20. SIGNS: Lessee shall have the right to display in or upon the leased property customary trade
signs, relating only to the business for which the leased property is leased. The character and location of
said signs shall be subject to the written approval of Lessor. Lessee shall not place any projecting sign,
marquee or awning on the front of the leased property without the written consent of Lessor. It is further
agreed that Lessee shall conform to the sign ordinance of the City of Carlsbad and pay any and all costs
connected with the installation of any signs, marquee or awning, including, but not limited to, any
permits or fees required by City of Carlsbad.
21. PEACEABLE SURRENDER: Upon the expiration of this lease or sooner termination or
cancellation thereof, as herein provided, Lessee will peaceably surrender said premises to Lessor in as
good condition as said premises were at the date of this lease, ordinary wear and tear excepted. If the
Lessee fails to surrender the premises at the expiration of this lease or the earlier termination or
cancellation thereof, Lessee shall defend and indemnify Lessor from all liability and expense resulting
from the delay or failure to surrender, including, without limitation, any succeeding Lessee’s claims
based on Lessee’s failure to surrender.
22. WAIVER Any waiver by Lessor of any breach by Lessee of any one or more of the covenants,
conditions, or agreements of this lease shall not be construed to be a waiver of any subsequent or other
breach of the same or any other covenant, condition or agreement of this lease, nor shall any failure on
the part of Lessor to require or exact full and complete compliance by Lessee with any of the covenants,
conditions, or agreements of this lease be construed as in any manner changing the terms hereof or to
prevent Lessor from enforcing the full provisions hereof. The subsequent acceptance of rent hereunder
by Lessor shall not be deemed to be waiver of any preceding breach by Lessee of any term, covenant, or
condition of this lease, other than the failure of Lessee to pay the particular rental so accepted, regardless
of Lessor’s knowledge of such preceding breach at the time of acceptance of such rent.
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23. HOLD OVER This lease shall terminate without further notice at expiration of the term. Any
holding over by Lessee after either expiration or termination shall not constitute a renewal or extension
or give Lessee any rights in or to the leased premises. If Lessee, with Lessor’s consent, remains in
possession of the leased premises after expiration or termination of the term or after the date in any
notice given by Lessor to Lessee terminating this lease, such possession by Lessee shall be deemed to be
a month-to-month tenancy terminable on thirty (30) days notice given at any time by either party.
During any such month-to-month tenancy, lessee shall pay all rent required by this lease. All provisions
of this lease, except those pertaining to term, shall apply to the month-to-month tenancy.
24. SECTJON HEADINGS: The Table of Contents and section headings contained herein are for
convenience in reference and are not intended to define or limit the scope of any provision thereof.
25. ENTIRE UNDERSTANDING: This lease contains the entire and only understanding and
agreement of the parties, and Lessee, by accepting the same, acknowledges that there is no other written
or oral understanding or agreement between the parties with respect to the demised premises and that this
lease supersedes all prior negotiations, discussions, obligations and rights of the parties hereto. No
waiver, modification, amendment or alteration of this lease shall be valid unless it is expressly in writing
and signed by authorized persons of the parties hereto. Each of the parties to this lease acknowledges
that no other party, nor any agent or attorney of any other party, has made any promise, representations,
waiver or warranty whatsoever, expressed or implied, which is not expressly contained in writing in this
lease, and, each party further acknowledges that it has not executed this lease in reliance upon any
collateral promise, representation, waiver or warranty, or in reliance upon any belief as to any fact not
expressly recited in this lease.
26. NOTICES: Notices given or to be given by Lessor or Lessee to the other may be personally
serviced upon Lessor or Lessee or any person hereafter authorized by either in writing to receive such
notice or may be served by certified letter addressed to the appropriate address hereinafter set forth or to
such other address as Lessor and Lessee may hereafter designate by written notice. If served by certified
mail, forty-eight (48) hours after deposit in the U.S. Mail, service will be considered completed and
binding on the party served.
To J.es%z
Colonial Mall City of Carlsbad
Carlsbad Professional Center Public Works Manager
1207 Carlsbad Village Drive, Suite J 405 Oak Avenue
Carlsbad, CA 92008 Carlsbad, CA 92008
27. REMOVAL OF MATERJALS: Lessee hereby agrees that upon the expiration of this lease or
the sooner termination as herein provided, it will remove within sixty (60) days debris, surplus and
salvage materials from the land area forming a part of or adjacent to the leased premises, so as to leave
the same in as good condition as when first occupied by Lessee; provided, however, that if any said
debris, surplus and salvage materials shall not be so removed within sixty (60) days by the Lessee,
Lessor may remove, sell and destroy the same at the expense of Lessee and Lessee hereby agrees to pay
to Lessor the reasonable cost of such removal, sale or destruction; or at the option of Lessor, the title to
said debris, surplus and salvage materials not removed shall become the property of Lessor without cost
to Lessor and without any payment to Lessee.
During any period of time employed by Lessee under this paragraph to remove debris, surplus
and salvage materials, Lessee shall continue to pay the full rental to Lessor in accordance with this lease
which said rental shall be prorated daily.
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P
28. ACCEPTANCE OF PREMISES: By signing this Lease, Lessee represents and warrants that it
has independently inspected the premises and made all tests, investigations and observations necessary
to satisfy itself of the condition of the premises. Lessee agrees it is relying solely on such independent
inspection, test, investigations and observations in making this Lease. Lessee further acknowledges that
premises are in the condition called for by this Lease, that Lessor has performed all work with respect to
premises and that Lessee does not hold Lessor responsible for any defects in premises.
29. QUIET POSSESSION: Lessee will at all times during the terms of this Lease occupy the
premises quietly and not commit any act, waste or nuisance which disturbs the quiet enjoyment of the
property for the Lessor, public, any neighbor or other tenant of Lessor.
30. ABSTRACT OF LEASE: This is the final paragraph and abstract of the lease dated
4 1999, between Colonial Mall, Lessor, and City of Carlsbad, Lessee concerning the
premises described in Exhibit “A” attached hereto and by this reference made a part hereof.
For good and adequate consideration, Lessor leases the premises to Lessee, and Lessee hires
them fi-om Lessor, for the term and on the provisions contained in the lease, including without limitation
provisions prohibiting assignment, subleasing, and encumbering said lease without the express written
consent of Lessor in each instance, all as more specifically set forth in said Lease, which said Lease is
incorporated in this abstract by this reference.
This abstract is not a complete summary of the lease. Provisions in the abstract shall not be
used in interpreting the lease provisions. In the event of conflict between the abstract and other parts of
the lease, the other parts shall control. Execution hereof constitutes execution of the lease itself
APPROVED as to form
and legality
B
C
LESSOR
‘ksq
Date
//-%$?a -99
Date
Signatures of Lessee and Lessor must be notarized.
CALIFORNlA.ALL-PffRPOSE-ACKNOWLEDGMENT - -. - ...- . -’ - -‘.. -
N personally known to me - OR - q proved to me on the basis of satisfactory evidence to
be the person(s) whose name(s)@‘are subscribed to
the within instrument and acknowledged t me that
&i? she/they executed the same in
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i her/their
authorized capacity(ies), and that by is her/their
signature(s) on the instrument the person(s), or the
entity upon behalf of which the person(s) acted,
executed the instrument.
eat; ‘.-
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 SIGNED
cl INDIVIDUAL
0 CORPORATE OFFICER
Tm-wl
DESCRfPTlON OF ATACHED DOCUMENT
TITLE OR TYPE OF DOCUMENT
0 PARTNER(S) cl LIMITED
cl NUMBER OF PAGES GENERAL
cl A-ITORNEY-IN-FACT
CITRUSTEE
0 GUARDIAN/CONSERVATOR
cl OTHER:
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENTlTY(1E.S)
DATE OF DOCUMENT
.
SIGNER(S) OTHER THAN NAMED ABOVE