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06-0112_WHISPERING HILLS , LLC_Labor & Material Bond SU5018273 (West Canyon - Storm Drain)Bond No.SU5018273 Premium: Included in cost of performance. LABOR AND MATERIAL BOND KNOW ALL MEN BY THESE PRESENTS: That WHEREAS, the City of San Juan Capistrano, a municipal corporation of Orange County, California, hereinafter called "City', has Dermitted'the construction of certain improvements to yW pering Hills, LLC, a Delaware Limited Liability Company . hereinafter called 'Contractor; and, WHEREAS, said improvements are more particularly described as follows: Tract 16634 West Canyon Whispering Hills - Storm Drain and, WHEREAS,.the Contractor is required to furnish a laborand material bond pursuant to the statutory requirements of the San Juan Capistrano Municipal Code to guarantee that if said Contractor, or any of his or its sub -contractors, shall fail to pay for any materials, provisions, provender or other supplies or teams used in, upon,. for or about the performance of the work to be done, or for any work or labor done thereon of any kind, the surety or this bond will pay the same. NOW, THEREFORE, we, the Contractor, and Arch Insurance company as surety, are held firmly bound unto the City of San Juan Capistrano, a municipal corporation, in. the penal sum of Three Hundred Fifty Six Thousand and 00/100 DOLLARS ($_ 156,nno.on —.—),lawful money of.the United States of America, for payment of which sum well and truly to be made we bind ourselves, o6rheirs, executors, administrators and successors, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION is such that, if said Principal, his or its heirs, executors, administrators, successors orassigns, orsub-contractors, shallfailto pay for any materials; provisions, provender, orteams, orothersupplies orequipment used in, upon, for or about the performance of the work to be done, or for any work or labor done thereon of any kind, or for amounts due under the Unemployment Insurance Act with respect to such work or labor as required by the provisions of TA161, Division 5, Chapter 3 of -the Government Code of California as amended, that the surety will pay for the same in an amount not exceeding the sum specified in this bond and also incase suit is brought upon the bond, a reasonable attorney's fee to be fixed by the court. This- bond shall inure to the benefit of any and all persons, companies and corporations entitled to file claims under said act, so as to give a right of action to them or their assigns in anysuit brought upon this bond. As a part of the obligation secured thereby, 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 City in successfully enforcing such obligation, all to be taxed as costs and included in any judgment rendered. IN WITNESS WHEREOF three (3) identical counterparts of this instrument, each of which shall for all purposes be deemed an original thereof, have been duly executed by the Contractor and surety herein named on the 12th . day of'_ January. 2006 . The name and corporate seal of each corporate paity being hereto affixed and these presents duly signed by its undersigned representatives pursuant to authority of its governing body. Whispering Hills, LLC, a Delaware Limited Liability Company CONTRACTOR Arch Insurance Company , Attorney -in -Fact APPROVED AS TO FORM , CITY ATTORNEY CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA ss. COUNTY OF ORANGE On January 27, 2006, before me, D Harvey, a Notary Public in and for said State, personally appeared Dennis Gage, personally known to me to be the person whose name is subcribed to the within instrument and acknowledged to me that he executed the some in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. ESS S1 izand-and-official-sgal. D. HARVEY CommWbn M 1516985 e Notary Public • California Orange County _ tdy Comm. Expires Oct 1, 2008 (seal) Notary Public Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Capacity(les) Claimed by Signer(s) Signer's Name: ❑ Individual []Corporate Officer ❑Title(s): ❑ Partner -- ❑ Limited —❑ General []Attorney -in -Fact []Trustee []Guardian or Conservator ❑ Other: Signer is Representing: Number of Pages Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑Corporate Officer ❑Title(s): ❑Partner-- ❑Limited --❑ General ❑ Attorney -in -Fact []Trustee ❑Guardian or Conservator ❑Other: Signer is Representing: CALIFORNIA ALL-PURPOSE&KNOWLEDGMENT • State of Cal ; orn; a County of orange On JAN 12 1005 before me, Paris Shahabi a Notary Public Meme and Tae of Officer (e.g.. 'Jane toe. Notary P.M.—) personally appeared Janina Monroe Names) of Signe(s) 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 PARA SHAHAlt his/her/their signature(s) on the instrument the person(s), �arr" hMlm f 16724M or the entity upon behalf of which the person(s) acted, pry Cawj*ou� executed the instrument. *Cc"M8"ft 2426pp WITNESS my hand and official seal. SignaWm ofNotary POhc OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(es) Claimed by Signer(s) Signer's Name: Signer's Name: ❑ Individual ❑ Corporate Officer ❑ Title(s): ❑ Partner — ❑ Limited ❑ General ® Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: BD -1133 9197 RIGHT THUMBPRINT OF SIGNER ❑ Individual ❑ Corporate Officer ❑ Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: • POWER OF ATTORNEY • Know All Men By These Presents: That the Arch Insurance Company, a corporation organized and existing under the laws of the State of Missouri, having its principal office in Kansas City, Missouri (hereinafter referred to as the "Company") does hereby appoint Victoria M. Campbell, Thomas G. McCall and Janina Monroe of Irvine, CA (EACH) its true and lawful Attorney(s)-in-Fact, to make, execute, seat, and deliver from the date of issuance of this power for and on its behalf as surety, and as its act and deed: Any and all bonds and undertakings EXCEPTION: NO AUTHORITY is granted to make, execute, seal and deliver bonds or undertakings that guarantee the payment or collection of any promissory note, check, draft or letter of credit. This authority does not permit the same obligation to be split into two or more bonds in order to bring each such bond within the dollar limit of authority as set forth herein. The Company may revoke this appointment at any time. The execution of such bonds and undertakings in pursuance of these presents shall be as binding upon the said Company as fully and amply to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at its principal office in Kansas City, Missouri. This Power of Attorney is executed by authority of resolutions adopted by unanimous consent of the Board of Directors of the Company on March 3, 2003, true and accurate copies of which are hereinafter set forth and are hereby certified to by the undersigned Secretary as being in full force and effect: "VOTED, That the Chairman of the Board, the President, or any Vice President, or their appointees designated in writing and filed with the Secretary, or the Secretary shall have the power and authority to appoint agents and attorneys -in -fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and other writings, obligatory in the nature thereof, and any such officers of the Company may appoint agents for acceptance of process." This Power of Attorney is signed, sealed and certified by facsimile under and by authority of the following resolution adopted by the unanimous consent of the Board of Directors of the Company on March 3, 2003: VOTED, That the signature of the Chairman of the Board, the President, or any Vice President, or their appointees designated in writing and filed with the Secretary, and the signature of the Secretary, the seal of the Company, and certifications by the Secretary, may be affixed by facsimile on any power of attorney or bond executed pursuant to the resolution adopted by the Board of Directors on March 3, 2003, and any such power so executed, sealed and certified with respect to any bond or undertaking to which it is attached, shall continue to be valid and binding upon the Company. OOMLOO13 00 03 03 Page 1 of 2 Printed in U.S.A. In Testimony Whereof, the Company } caused this instrument to be signed an, corporate seal to be affixed by their authorized officers, this 21st day of Marcn, 2003. Arch Insurance Company Attested and Certified �T 4� . � WRroatti Jos , . Labels, Corporate Secretary kitsrrd� STATE OF CONNECTICUT SS COUNTY OF FAIRFIELD SS Thomas P. Luckstone, Vice President I Melissa 3. Gilligan, a Notary Public, do hereby certify that Thomas P. Luckstone and Joseph S. Labell personally known to me to be the same persons whose names are respectively as Vice President and Corporate Secretary of the Arch Insurance Company, a Corporation organized and existing under the laws of the State of Missouri, subscribed to the foregoing instrument, appeared before me this day in person and severally acknowledged that they being thereunto duly authorized signed, sealed with the corporate seal and delivered the said instrument as the free and voluntary act of said corporation and as their own free and voluntary acts for the uses and purposes therein set forth. CERTIFICATION �1'02&!i /LQr"�2 Melissa B. Gltigan, Notary Puts ie My rommisslon expires 2-28-05 I, Joseph S. Labell, Corporate Secretary of the Arch Insurance Company, do hereby certify that the attached Power of Attorney dated March 21, 2003 on behalf of the person(s) as listed above is a true and correct copy and that the same has been in full force and effect since the date thereof and is in full force and effect on the date of this certificate; and I do further certify that the said Thomas P. Luckstone, who executed the Power of Attorney as Vice President, was on the date of execution of the attached Power of Attorney the duly elected Vice President of the Arch Insurance Company. IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seal of the Arch Insurance Company on this day of IAN 1 2 2006 20_ h Jos .Labell, Corporate Secretary This Power of Attorney limits the acts of those named therein to the bonds and undertakings specifically named therein and they have no authority to bind the Company except in the manner and to the extent herein stated. Home Office: Kansas 1:r.. MO OOML0013 00 03 03 srht Page 2 of 2 "r E Printed in U.S.A. Cissorrl ARCH Insurance Company ARCH Surety NOTICE — DISCLOSURE OF TERRORISM PREMIUM In accordance with the Terrorism Risk Insurance Act of 2002, we are providing this disclosure notice for bonds on which Arch Insurance Company is the surety. DISCLOSURE OF PREMIUM The portion of the premium attributable to coverage for terrorist acts certified under the Act is Zero Dollars ($0.00). DISCLOSURE OF FEDERAL PARTICIPATION IN PAYMENT OF TERRORISM LOSSES The United States will pay ninety percent (90%) of covered terrorism losses exceeding the applicable insurer deductible. 0 r� u ARCH INSURANCE COMPANY ENDORSEMENT Bond Number: SU 5018272 To be attached to and form a part of Tract 16634 West Canyon Whispering Hills - Sanitary Sewer Bond, issued by the undersigned company, as Surety on behalf of Rancho San Juan Development LLC. a Delaware limited liability company as Principal, in favor of City of San Juan Capistrano as Obligee, Effective 4/07/2009, the Principal and the Surety hereby agree to amend the attached bond as follows: Principal Name Change: From: Whispering Hills, LLC To: Rancho San Juan Development LLC All else remains the same. Provided that the liability under this endorsement shall be part of, and not in addition to, the liability under the attached Bond, and in no event shall be cumulative. Nothing herein contained shall vary, alter or extend any of the provisions, conditions, or other terms of this bond except as above stated. SIGNED, SEALED, DATED: 4/072009 RANCHO SAN JUAN DEVELOPMENT LLC, a Delaware limited liability company (Principal) By: Woodbridge Builders, LLC, a Delaware limited liability company Its Manager Member By: Woodbridge Communities 11, LLC, a Delaware limited liability mpany Its Manager By: To unningham, Its Manager ARCH INSURANCE COMPANY (Surety) DIRECT CORRESPONDENCE TO: ARCH CONTRACTORS 8 DEVELOPERS GROUP, 135 N. LOS ROBLES AVE., #825, PASADENA, CA 91101 PHONE (626) 639-5200 • FAX (626) 639-5210 0 CALIFORNIA••ACKNOWLEDGMENT STATE OF CALIFORNIA Cl County of Orange J OAPR 0 7 2009 before me, Michelle Haase. Notary Public Date Here Inserl ame and Title of the onicer personally appeared Janina Monroe Names) of signer(s) WCHELLE HAASE Corrmrission ♦ 181M38 Notary Public - California Orange Coolly M Comm. ' Ira Au 22.2012 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 thathe/she/lhey executed the same in-IiWher/their authorized capacity(ies1, and that by-iais/her/I#reic signature* on the instrument the person(e) or the entity upon behalf of which the persons} 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. �� Signature Jl�J,&)J6 � -,/ Place Notary Seal Above Signature o Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Capacity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer —Title(s):_ ❑ Partner — ❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer—Title(s): ❑ Partner —❑ Limited ❑ General ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 02007 National Notary Association, 9350 Do Sam Ave., P.O.9az 2402-Ohatsw , CA 91319-2402 -a NatlonalNotaryorg Item #5907 Revaler. Can To ee 1-800-979-8827 0 0 STATE OF CALIFORNIA COUNTY OF _C) Q,YtLI P. I On 07 9009 before me, kayfet, i' l - r&'rn a Notary Public, personally appeared who proved to me on the basis of satisfactory evidence to be the person(e) whose name(&) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his4w/their authorized capacity(ies), and that by his/11eF/t#�signature(s}on the instrument the person(&} or the entity upon behalf of which the person(sj 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. LAUREN EITTREIM COMM FLO. # 1716475 ''^^ NOTARY PUBLIC -CALIFORNIA W ORANGE COUNTY MY COMM. ExP. JAN. 13, 2011 Signature (Seal) Capacity Claimed by Signer ❑ Individual ❑ Corporate Officer Title ❑ Partner(s) ❑ Attorney -in -Fact ❑ Trustee(s) ❑ Guardian/Conservator 0 Other: OPTIONAL INFORMATION Description of Attached Document Title or Type of Document Date of Document Number of Pages I* POWER OF ATTORNEY* Know All Men By These Presents: That the Arch Insurance Company, a corporation organized and existing under the laws of the State of Missouri, having its principal office in Kansas City, Missouri (hereinafter referred to as the "Company") does hereby appoint Paul Boucher, Susan Thurston, Janina Monroe, Timothy J. Noonan, Leonard G. Fodemski and Mark Zwickel of Los Angeles, CA (EACH) its true and lawful Attomey(s}in-Fact, to make, execute, seal, and deliver from the date of issuance of this power for and on its behalf as surety, and as its act and deed: Any and all bonds and undertakings EXCEPTION: NO AUTHORITY is granted to make, execute, seal and deliver bonds or undertakings that guarantee the payment or collection of any promissory note, check, draft or letter of credit. This authority does not permit the same obligation to be split into two or more bonds in order to bring each such bond Within the dollar limit of authority as set forth herein. The Company may revoke this appointment at any time. The execution of such bonds and undertakings in pursuance of these. presents 'shall be as binding upon the said Company as fully and amply to all intents and purposes, as if the same had been duly executed and acknowledged by its regularly elected officers at its principal office in Kansas City, Missouri. This Power of Attorney is executed by authority of resolutions adopted by unanimous consent of the Board of Directors of the Company on March 3, 2003, true and accurate copies of which are hereinafter set forth and are hereby certified to by the undersigned Secretary as being in full force and effect "VOTED, That the Chairman of the Board, the President, or any Vice President, or their appointees designated in writing and filed with the Secretary, or the Secretary shall have the power and authority to appoint agents and attomeys-in-fact, and to authorize them to execute on behalf of the Company, and attach the seal of the Company thereto, bonds and undertakings, reoognizances, contracts of indemnity and other writings, obligatory in the nature thereof, and any such officers of the Company may appoint agents for acceptance of process." This Power of Attorney is signed, sealed and certified by facsimile under and by authority of the following resolution adopted by the unanimous consent of the Board of Directors of the Company on March 3, 2003: VOTED, That the signature of the Chairman of the Board, the President, or any Vice President, or their appointees designated in writing and filed with the Secretary, and the signature of the Secretary, the seal of the Company, and certifications by the Secretary, may be affixed by facsimile on any power of attorney or bond executed pursuant to the resolution adopted by the Board of Directors on March 3, 2003, and any such power so executed, sealed and certified with respect to any bond or undertaking to which it Is attached, shall continue to be valid and binding upon the Company. OOML0013 00 03 03 Page 1 of 2 Printed in U.S.A. In Testimony Whereof, the Company has caused this instrument to be signed and its corporate seal to be affixed by their authorized officers, this 1 st day of May 2008 Attested and Certified ev` Ce co C9RpR�TE �'4r SFLL L 666 19]1 R„�i � Ylssood Martin J. Nil #, Secretary STATE OF PENNSYLVANIA SS COUNTY OF PHILADELPHIA SS Arch Insurance Company rZ 59i 11 I Fiji F, 1, R A 1 r ,— I, Brian C. Kuhn, a Notary Public, do hereby certify that Martin J. Nilsen and J. Michael Pete personally known to me to be the same persons whose names are respectively as Secretary and Vice President of the Arch Insurance Company, a Corporation organized and existing under the laws of the State of Missouri, subscribed to the foregoing instrument, appeared before me this day in person and severally acknowledged that they being thereunto duly authorized signed, sealed with the corporate seal and delivered the said instrument as the free and voluntary act of said corporation and as their own free and voluntary acts for the uses and purposes therein set COAASONWEILIH OF PBDMSYLVANIA NOTARIAL SEAL �- Lcmi:c: rian C. Kuhn, Nose yy PubHc Brian C. Kuhn; NotaryPublic fPhiladelphia PhiladelphiaCoanry My commission expires 12-06-2011 CERTIFICATION mmisaionespireaDecemberD6,2011 1, Martin J. Nilsen, Secretary of the Arch Insurance Company; do hereby certify that the attached Power of Attorney dated May 1, 2008 on behalf of the person(s) as listed above is a true and correct copy and that the same has been in full force and effect since the date thereof and is in full force and effect on the date of this certificate; and I do further certify that the said J. Michael Pete, who executed the Power of Attorney as Vice President, was on the date of execution of the attached Power of Attorney the duly elected Vice President of the Arch Insurance Company. IN TESTIMONY WHEREOF, I have hereunto subscribed my name and aff ed the corpo s 1 of the Arch Insurance Company on this day of APR 0 7 2@gT, 20_ Martin J. Nil , Secretary This Power of Attorney limits the acts of those named therein to the bonds and undertakings specifically named therein and they have no authority to bind the Company except in the manner and to the extent herein stated. PLEASE SEND ALL CLAIM INQUIRIES RELATING TO THIS BOND TO THE FOLLOWING ADDRESS: Arch Contractors & Developers Group 135 N. Robles Ave., Ste. 825 Pasadena, CA 91101 OOML0013 00 03 03 Page 2 of 2 COgCRATF t+ F� iksad Printed in U.S.A. • Bond No.SU5018272 Premium: $ i,680.00 PERFORMANCE BOND KNOW ALL MEN BY THESE PRESENTS: That Whispering Hills, LLC, a Delaware Limited Liability Company as Principal, hereinafter called CONTRACTOR, and Arch Insurance company, as Surety, hereinafter called SURETY, are hell and firmly bound unto the City of San Juan Capistrano, as Obligee, hereinafter called CITY, in the amount of one Hundred Sixty Eight Thousand s 00/100 ($168,000.00) Dollars for payment whereof Contractor and Surety bind themselves, their heirs, executors, administrators, successors, and assigns, jointly and severally, fairly by these presents.. WHEREAS, Contractor has by written agreement dated entered into a (describe agreement): Tract 16634 west Canyon Whispering Hills - Sanitary Sewer which contract is by reference made a part hereof, NOW THEREFORE, the condition of this obligation is such that, if Principal shall promptly and faithfully perform said agreement, then this obligation shall be null and void; otherwise it shall remain in full force and effect Surety waives whatever legal right it may have to require that a demand be made first against the principal in the event of default. BE IT FURTHER RESOLVED, that: 1. As a part of the obligation secured hereby, and in addition to the face amount specified, there shall be included costs and reasonable expenses and fees, including reasonable attorney's fees, incurred by City in successfully enforcing such obligation, all to be taxed as costs and included in any judgment rendered. 0 2. Said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration, or mod'fication of the contract documents or of the work to be performed thereunder, shall in any way affect its obfigations or this bond, and it does hereby waive notice of any such change, extension of time, alterations, or modifications of the contract documents or of work to be performed thereunder. Executed this 12th day of January_ Irvine . California. APPROVED AS TO FORM QAP =- — JO R. SHAW, CITY ATTORNEY 200_ 6 at PRINCIPAL Whispering Hills, LLC, a DeLmmrp Limited Liability Company (NOTARIZATION AND SEAL) Insurance Company Ja i a Monroe ALL (NOTAPAZATION AND SEAL) CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT STATE OF CALIFORNIA ss. COUNTY OF ORANGE On January 27, 2006, before me, D Harvey, a Notary Public in and for said State, personally appeared Dennis Gage, personally known to me to be the person whose name is subcribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature on the instrument the person, or the entity upon behalf of which the person acted, executed the instrument. o ic'al seal. D. IiARVEY a Commissbn k 1516985 Y • `W Notary public • C0111ofnio Orange County My Comm. Expires Oct 1, 2008 Signature of Not ry ublic (seal) Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document Date: Signer(s) Other Than Named Above: Copocity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑Corporate Officer ❑Title(s): ❑ Partner -- 01imited—❑ General []Attorney -in -Fact ❑Trustee ❑Guardian or Conservator [--]Other: Signer is Representing: Number of Pages Copocity(ies) Claimed by Signer(s) Signer's Name: ❑ Individual ❑Corporate Officer ❑Title(s): ❑ Partner -- ❑ Limited —❑ General ❑ Attorney -i n -Fact []Trustee ❑Guardian or Conservator ❑Other: Signer is Representing: CALIFORNIA ALL-PURPOSESPKNOWLEDGMENT . State of California County of Orange On JAN 12 2606 before me, Paris Shahabi, Notary Public Name aM Title of Officer (e.g., -Jane Doe. Notary Public') personally appeared Janina Monroe Names) of Signerfa) 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 lYM� lIIMUII same in his/her/their authorized capacity(ies), and that by Cott **m s 16T1404 h s/her/their signature(s) on the instrument the person(s), �V MW • cdom 0 or the entity upon behalf of which the person(s) acted, o�� Caw* executed the instrument. WITNESS my hand and official sea/` 41 Signature of Notary Public OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Description of Attached Document Title or Type of Document: Document pate: Signer(s) Other Than Named Above: Capacity(es) Claimed by Signer(s) Signer's Name: ❑ Individual ❑ Corporate Officer ❑ Title(s): ❑ Partner — ❑ Limited ❑ General ® Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Top of thtanb here Signer Is Representing: BD -1133 9197 Number of Pages: Signer's Name: ❑ Individual ❑ Corporate Officer ❑ Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Attorney -in -Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: — Signer Is Representing: RIGHT THUMBPRINT OF SIGNER