Mariposa Landscape Inc.A R 1 P O S A
L A N D S C A P E S I N C
Bid Letter
September 7, 2011
City of Rosemead
8838 E. Valley Blvd
Rosemead, CA. 91770
Re: Garvey Ave Median Landscape Irprovements; Project No. 21845
Thank you for the opportunity to submit a proposal for the City of Rosemead Garvey Avenue
Median Landscape Improvements. Mariposa Landscapes, Inc. looks forward to the competitive
process and hopes to be the successful bidder.
For over 30 years, we have been in business providing similar services for other cities. Our depth of
knowledge and level of experience in our management and supervisory personnel is unmatched by
our competitors. Our area of operation is the entire Southern California area where we maintain
numerous cities, municipalities, government agencies, and private entities. We have over 300
employees and are able to provide the landscape maintenance and related services that the City of
Los Angeles requires and needs.
We have thoroughly reviewed all the site conditions. Our price reflects all the necessary labor,
equipment and material to perform this work. All work will be performed in strict accordance with
the specifications of the RFP.
Total Base Bid (Schedule Bid Price) ........................ ............................... `4 U I Oi? • 6 O
Sxt �i - s� v��1 tnwscr cl One YIondre d and ° /iob boll ms
Bid Bond Amount ..................................................... ............................... Ten Percent (10 %) of Total Base Bid
Acknowledgement of Receipt of Addenda No.
Contractors License No.: 592268
Class C -27, A, C61 /D49
Expires: 4 /30/2012
15529 ARROW HIGHWAY, IRWINDALE, CA 91706
CA, LANDSCAPE CONTRACTORS LICENSE NO. 592268
TEL. 626 9 960.0196 FAX 626 9 960.8477
State of California
Y JUL 31
STATEMENT OF INFORMATION
(Domestic Stock and Agricultural Cooperative Corporations)
FEES (Filing and Disclosure): $25.00. If amendment, see Instructions.
IMPORTANT — READ INSTRUCTIONS BEFORE C,O1GmPLETINC THIS FORM
I. CORPORATE NAME (Please do not after If name is preprinted.)
01469653
MARIPOSA HORTICULTURAL ENTERPRISES,
INC.
15529 ARROW HIGHWAY
IRWINDALE CA 91706
® [ oil
i�
L J I,V: f.dV:F1V I pvwT appucaote Ir agem address of record is a P.O. Box address See instructions )
2 If there has been no change in an of the Irtforma"on contained In the last Statement of fnfonnatlon, led with the Galifomia Secrets
State, check the box and proceed to it 16.
If there have boon any changes to the Information corHainetl in the last Statement of information filed with the California Secretary of E
Or no statem e_ntfIss_been DrevloastV filed_ thjc form mr:N ho n .,mnlc4nd:.. a� e.,rr�n.
3. STREETAODRESS OF PRINCIPAL EXECUTIVE OFFICE
CRY
STATE A ZIP CODE
4. STREET ADDRESS OF PRINCIPAL, BUSINESS OFFICE IN CALIFORNIA, IF ANY
CITY
, a1 9 fd3IcrFyL
_ _
ZA.S
STATE
ZIP CODE
S. MAILING ADDRESS OF CORPORATION, IF DIFFERENT THAN ITEM 3
CITY
CA
STATE
ZIPCODE
11. NAME
STATE
.ZIP CODE
NAMES AND COMPLETE ADDRESSIES OF TOE FOLLOWING OFFICERS (The corporation must have these th roe
for the s ecl4c officer may be added; however, the elldnted t1fleS on this form
must not be altered.)
ottkers.
A CamParahle
B. CHIEF EXECUTIVE OFFICER/ ADDRESS
CITY
TERRY NORIEGA 15529 ARROW HIGHWAY
IRWINDALE
STATE
CA
ZIP CODE
7. SECRETARY/ ADDRESS
CRY
91706
ANTONIO VALENZUEEA 15529 ARROW HIGHWAY
IRWINDALE
STATE
W OODE
S CHIEF FINANCIAL OFFICER( ADDRESS .
CffY
CA
0
X1706
m WV6 0A T n ,.. �..,. .__�_ _-
STATE
Zed Cn
l went t-; I VrRi, 4r4 t:l_u1� HW nfRE1CTORS WHO ARE ALSO OFFICERS (Tlta corparatfol
at least one direc tor. Attacb additional oaaes. if nernacaw t
9. NAA'E
TERRY NORIEGA
ADDRESS
15529.AR$Ot�t H AY IG
STATE
ZIP DE
_
70. NAME
, a1 9 fd3IcrFyL
_ _
ZA.S
ADDRESS CRY
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_9
STATE
ZIPCODE
11. NAME
ADDRESS CRY
_
STATE
ZIP CODE
.+..c.. r ram xrsvn,c tit-
PROCESS (if the agent is an Indtvtdual, the agent must ieside In Califomia ertd item 14 must be
street address (a P.O. Box address Is not acceptable). If the agent 1s another cwporatfon, the agent must h c o ompl S m
ce pumuiut to Co aborts Code section 1505 and Item 14 must be left blank.) ave on 01e with the Cal
13. NAME OFAQENT FOR SERVICE OF PROCESS
STE:INS,ANDELSON,LOYA,RMW & ROMO
14. STFTEETADORESS oFAGENT FOR SERVICE OF PROCESS IN CALIFORNIA, IF AN tNDMDDA,f. C11Y
STATE ZJPCODiE
75. DESCRIBE THE TYPE OF BUSINESS OFTHE CORPORATION
LANDSCAPE CONTRACTOR
S. BY SUBMITTING THIS STATEMENT OF INFORMATION TO THE CALIFORNIA SECRETARY OF STATE, �ORPORgTIt�V CERTIFIES THE INFCIR
�I, rf�fj1,Y IS TRUE AND CORRECT. ,� 1 `]^
AUOODUD3
Late of California
Secretary of State
I, DEBRA BOWEN, Secretary of State of the State of
California, hereby certify:
That the attached transcript of page(s) has been compared
with the record on file in this office, of which it purports to be a copy, and
that it is full, true and correct.
IN WITNESS WHEREOF, I execute this
certificate and affix the Great Seal of the
State of California this day of
NOV 2 5 2008
SeafStafe Form CE -107 (REV 112007) @0 q$P06 89M
A:Qb8b8.J
CERTIFICATE OF AMENDMENT
OF
ARTICLES OF INCORPORATION
OF
office of the Secretary of State
of the State of California;
Nov r 2008
MARIPOSA HORTICULTURAL ENTERPRISES, INC.
The undersigned certify that:
I. They are the President and Secretary, respectively of Mariposa Horticultural
Enterprises, Inc., a California corporation.
2. Article I of the Articles of Incorporation of this corporation is amended to read as
follows:
`"The name of this corporation is Mariposa Landscapes, Inc."
3. The foregoing amendment of Articles of Incorporation has been duly approved by
the board of directors.
4. The foregoing amendment of Articles of Incorporation has been duly approved by
the required vote of shareholders in accordance with Section 902 of the California Corporations
Code. The total number of outstanding shares of the corporation is 1,000. The number of shares
voting in favor of the amendment equaled or exceeded . the vote required. The percentage vote
required was more than 50 %.
I further declare under penalty of perjury . under the laws of the State of California that the
matters set forth in this certificate are true and correct of my own knowledge.
Dated: III�� , 2008 `
Terry Noriega, President
U (hJV
Antonio Valemela, Secretary
003566.00007/1077053v1
BIDDER: Mariposa Landscapes, Inc.
CBF -1
BIDDER: Mariposa Landscapes, Inc.
BID SCHEDULE
SCHEDULE OF PRICES FOR
GARVEY AVENUE MEDIAN LANDSCAPE IMPROVEMENTS PROJECT
PROJECT No. 21845
BASE BID SCHEDULE
TOTAL BASE BID PRICE (SCHEDULE BID PRICE) :$ 4 , ) 00 • yb
sigq-&ven +hwsclnd one hundred nod 'hob Iailwg
Dollar amount in written form
Note: The City of Rosemead reserves the right to reduce or increase the quantifies of any items in
the schedule of bid items above, within the limits define in Section 3 -2.2.1 of the Standard
Specifications, to stay within the budgeted amount of this project.
If the Bid Documents specify alternate bid items, the following Alternate Bid amounts shall
be added to or deducted from the Total Bid Price entered above. The owner can choose to
include one or more of the alternates in the Total Bid Price of the Project. If any of the
Alternate Bids are utilized by the Owner, the resulting amount shall be considered the Total
Bid Price for the Project.
The undersigned agrees that these Contract Bid Forms constitute a firm offer to the Owner which
cannot be withdrawn for the number of Working Days indicated in the Notice Inviting Bids from and
after the bid opening date, or until a Contract for the Work is fully executed by the Owner and a third
party, whichever is earlier. The undersigned also agrees that if there is a discrepancy between the
written amount of the Bid Price and the numerical amount of the Bid Price, the written amount shall
govern.
CBF -2
UNIT OF
EST.
UNIT
ITEM
NO.
ITEM DESCRIPTION
MEASURE
QTY.
PRICE
COST
1
Clearing& Grubbing per plans
LS
1
y cq� 6�g
and specifications. See technical
+
provisions TP -2, TP -3 & TP -4.
2
Disposal of Waste Materials.
LS
1 2 ,
OGo �D�,C
DO
3
Install Landscape including river
LS
1
� 30, qaD• 00
i7,q(x� • b0
rocks per Plans and
Specifications Complete,
4
Install and Modify Irrigation
LS
1
4 Ub
oC 00
System per Plans and
1 100'
,1 •
Specifications Complete.
TOTAL BASE BID PRICE (SCHEDULE BID PRICE) :$ 4 , ) 00 • yb
sigq-&ven +hwsclnd one hundred nod 'hob Iailwg
Dollar amount in written form
Note: The City of Rosemead reserves the right to reduce or increase the quantifies of any items in
the schedule of bid items above, within the limits define in Section 3 -2.2.1 of the Standard
Specifications, to stay within the budgeted amount of this project.
If the Bid Documents specify alternate bid items, the following Alternate Bid amounts shall
be added to or deducted from the Total Bid Price entered above. The owner can choose to
include one or more of the alternates in the Total Bid Price of the Project. If any of the
Alternate Bids are utilized by the Owner, the resulting amount shall be considered the Total
Bid Price for the Project.
The undersigned agrees that these Contract Bid Forms constitute a firm offer to the Owner which
cannot be withdrawn for the number of Working Days indicated in the Notice Inviting Bids from and
after the bid opening date, or until a Contract for the Work is fully executed by the Owner and a third
party, whichever is earlier. The undersigned also agrees that if there is a discrepancy between the
written amount of the Bid Price and the numerical amount of the Bid Price, the written amount shall
govern.
CBF -2
BIDDER: Mariposa Landscapes, Inc.
Attached hereto is a certified check, a cashier's check or a bid bond in the amount of
10% Dollars ($ —___) said amount being not less than ten percent (10 / U) of the Total
Bid Price. The undersigned agrees that said amount shall be retained by the Owner if, upon award,
we fail or refuse to execute the Contract and furnish the required bonds, certificates and
endorsements of insurance and other certifications within the time provided.
If awarded a Contract, the undersigned agrees to execute the formal Contract, which will be
prepared bythe Owner for execution, within five (5) Calendar Days following the Letter of Award for
the Contract, and will deliver to the Owner within that same period the necessary original Certificates
of Insurance, Endorsements of Insurance, Performance Bond, Payment Bond and all other
documentation and certification required by the Contract.
The undersigned offers and agrees that if this bid is accepted, it will assign to the purchasing body
all rights, title, and interest in and to all causes of action it may have under Section 4 of the Clayton
Act (15 U.S.C. Section 15) or under the Cartwright Act (Chapter 2 of Part 2 of Division 7 of the
Business and Professional Code), arising from purchases of goods, materials or services by the
Bidder for sale to the purchasing body pursuant to the bid. Such assignment shall be made and
become effective at the time the purchasing body tenders final payment to he Contractor.
Bidder understands and agrees that, when requested by Owner, he shall provide: (1) evidence
satisfactory to the Owner of Bidder's California contractor's license(s) in good standing; (2) evidence
that the person signing this Bid is authorized to bind Bidder to this Bid and to a contract resulting
therefrom; and (3) any other information and documentation, financial or otherwise, needed by
Owner to award a Contract to the lowest responsible and responsive bidder.
Bidder understands and agrees that liquidated damages shall apply to this Contract in the amounts
of five hundred dollars ($500.00) if project is not completed in forty -five (45) calendar days. The
Contract Time will begin to run ten (10) Working Days from the date of the Notice of Proceed and
subject to the terms and conditions described in the Contract Form and the Contract Documents.
Bidder acknowledges that data submitted with its Contract Bid Forms which it requires to be
incorporated into a Contract arising out of this Submittal has been so identified by Bidder. Bidder
further acknowledges that the Owner may, at its discretion, incorporate any of the remaining data
submitted herewith into a contract arising out of this Bid.
The undersigned acknowledges receipt, understanding and full consideration of the following
addenda to the Contract Documents.
Addenda Nos. tJONu
The Bidder understands and agrees that the Total Bid Price is inclusive of all labor, materials, and
equipment or supplies necessary to complete the Work as described in the Bid Documents. If this
bid is accepted, the undersigned Bidder agrees to enter into and execute the Contract with the
necessary bonds and accept the Total Bid Price as compensation in full for all Work under the
contract.
CBF -3
By:
Sign ure
Terry Noriega
Type or Print Name
President
Title
BIDDER: Mariposa Landscapes, Inc.
15529 Arrow Highway
Business Street Address
Irwindale, CA 91706
City, State and Zip Code
626- 960 -0196
Telephone Number
Bidder's /Contractor's State of Incorporation: California
Partners or Joint Venturers:
Bidder's License Number(s): 592268
NOTES:
1)
2)
3)
By its signature on this Bid, the Bidder certifies under penalty of perjury the accuracy of the
representations made on the Contract Bid Forms.
If Bidder is a corporation, enter State of Incorporation in addition to Business Address
If Bidder is a partnership or joint venture, give full names of all partners or joint
venturers.
As further discussed in the Instructions to Bidders, Bidder will be required
to provide evidence that the person signing on behalf of the corporation,
partnership or.foint venture has the authority to do so.
CBF -4
BIDDER: Mariposa Landscapes, Inc.
SECTION 2
BID DATA F
CBF -5
BIDDER: Mariposa Landscapes, Inc.
2.13 LIST OF P SUBC ONTRACTORS
In compliance with the "Subletting and Subcontracting Fair Practices Act," Sections 4100
through 4114 of the California Public Contract Code, and any amendments thereto, each
Bidder shall provide the information requested below for each subcontractor who will
perform work, labor or render service to Bidder in or aboutthe construction of the Work in an
amount in excess of one -half of one percent (greater than 0.5 %) of the Bidder's Total Bid
Price, or, in the case of bids or offers for the construction of streets or highways, including
bridges, in excess of one -half of 1 percent of the Contractor's total bid or ten thousand
dollars ($10,000), whichever is greater, and shall further set forth the portion of the Work
which will be done by each subcontractor. Bidder shall list only one subcontractor for any
one portion of the Work.
Pursuant to Public Contract Code Section 4104, the Owner has determined that it will allow
Bidders twenty -four (24) additional hours after the deadline for submission of bids to submit
the information requested bythe Owner about each subcontractor, other than the name and
location of each subcontractor.
If the Bidder fails to specify a subcontractor for any portion of the Work to be performed
under the Contract, it shall be deemed to have agreed to perform such portion itself, and
shall not be permitted to subcontract that portion of the Work except under the conditions
hereinafter set forth below.
Subletting or subcontracting of any portion of the Work in excess of one half of one percent
(greater than 0.5 %) of the Total Bid Price or, in the case of bids or offers for the construction
of streets or highways, including bridges, in excess of one -half of 1 percent of the
Contractor's total bid or ten thousand dollars ($10,000), whichever is greater, for which no
subcontractor was designated in the original bid shall only be permitted in cases of public
emergency or necessity, and then only after Owner approval.
CBF -7
BIDDER: Mariposa Landscapes, Inc
23 LIST OF PROPOSED SUBCONTRACTORS (continued)
(°Duplloate Next 2 Pages if naoded for Ilsfing atldgionat subcontractors.)
Name and Location Description of Work
of Subcontractor to be Subcontracted
Name: 0GYItL
Address:
Name and Location
of Subcontractor
Name:
Address:
Description of Work
to be Subcontracted
Name and Location
of Subcontractor
Name:
Address:
Name and Location
of Subcontractor
Name:
Address:
Name and Location
of Subcontractor
Name:
Address:
Description of Work
to be Subcontracted
Description of Work
to be Subcontracted
Description of Work
to be Subcontracted
BIDDER: Mariposa Landscapes, Inc.
2.0
The following are the names, addresses and telephone numbers for three public agencies for which BIDDER
has performed similar work within the past two (2) years:
1. City of Montclair; 5111 Benito Ave, Montclair, CA 91763
Name and Address of Owner
Michael Hudson; 909- 626 -8571
Name and telephone number of person familiar with project
$548,939.00 Lanscape Construction 2009
Contract amount Type of Work Date Completed
2. El Monte Union High School; 1003 Durfee Ave, So. El Monte, CA 91733
Name and Address of Owner
Rosana McLeod; 626-258-4905
Name and telephone number of person familiar with project
$175,216.00 Landscape Construction Dec., 2010
Contract amount Type of Work Date Completed
3. City of Pasadena; 233 W. Mountain Ave, Room 255, Pasadena, CA 91103
Name and Address of Owner
Rosa Laveaga;626- 744 -3883
Name and telephone number of person familiar with project
Construction July 2010
Contract amount Type of Work Date
4, City of Fillmore; 250 Central Ave, Fillmore, CA 93015
Name and Address of Owner
Tom Ristau; 310 - 231 -7060
Name and telephone number of person familiar with project
$591,739.00 Landscape Construction Feb., 2009
Contract amount Type of Work Date Completed
BIDDER: Mariposa Landscapes, Inc.
SECTION 3
N ON-COLLUSION AFFIDA
CBF -10
BIDDER: Mariposa Landscapes, Inc.
NON - COLLUSION AFFIDAVIT
In accordance with Public Contract Code Section 7106, the undersigned, being first duly
sworn, deposes and says that he or she holds the position listed below with the bidder, the
party making the foregoing bid, that the bid is not made in the interest of, or on behalf of, any
undisclosed person, partnership, company, association, organization, orcorporation; that the
bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced
or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly
colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham
bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly
or indirectly, sought by agreement, communication, or conference with anyone to fix the bid
price of the bidder or any other bidder; or to fix any overhead, profit, or cost element of the
bid price, or of that of any other bidder, or to secure any advantage against the public body
awarding the contract of anyone interested in the proposed contract; that all statements
contained in the bid are true; and, further, that the bidder has not, directly or indirectly,
submitted his or her bid price or any breakdown thereof, orthe contents thereof, or divulged
information or data relative thereto, or paid, and will not pay, any fee to any corporation,
partnership, company association, organization, bid depository, or to any member or agent
thereof to effectuate a collusive or sham bid. A
Signature
Terry Noriega
Typed or Printed Name
President
Title
Landscapes, Inc.
Bidder
Subscribed and sworn before me
This _.,._ day of 20_
(Seal)
Notary Public in and for
the State of California
My Commission Expires:
CBF - 11
BIDDER; Mariposa Landscapes. Inc.
Bidder shall submit its Bid data in accordance with the format shown on each of the following Bid
Data Forms, Bidders shall prepare and use as many sheets as are necessaryto adequately provide
the information required. Bidder shall ensure that every page of its Bid Data Forms are properly
identified with the Bidder's name and page number.
2,A BID BONA
KNOW ALL MEN BY THESE PRESENTS:
THAT Mariposa Landscapes Inc. as
Principal, and Safeco Insurance Company of America
, as Surety, are held firmly bound unto the
CITY OF ROSEMEAD (hereinafter called the OWNER) in the sum of
( 10% ), being not less than ten percent (10 %) of the Total
Bid Price; for the payment of which sum will and truly to be made, we bind ourselves,
our heirs, executors, administrators, successors, and assigns, jointly and severally,
firmly by these presents.
WHEREAS, said Principal has submitted a bid to the OWNER to perform all Work
required forthe Garvey Avenue Median Landscape Improvements Project as set
forth In the Notice inviting Bids and accompanying Bid Documents, dated
September 7 2011
NOW, THEREFORE, if said Principal is awarded a Contract for the Work by the
OWNER and, within the time and in the manner required by the above- referenced
Bid Documents, enters into the written form of Contract bound with said Bid
Documents, furnishes the required bonds (one to guarantee faithful performance
and the other to guarantee payment for labor and materials) furnishes the required
insurance certificates and endorsements, and furnishes any other certifications as
may be required by the Contract, then this obligation shall be null and void;, otherwise
it shall remain in full force and effect. In the event suit is brought upon this bond by
the OWNER and judgment is recovered, said Surety shall pay all costs incurred by
the OWNER in such suit, including reasonable attorneys' fees to be fixed by the
court.
SIGNED AND SEALED, this 6th day of September , 2011
Mariposa Landscapes Inc. (SEAL)
Principal �/ {
Signature
Safeco Insurance
Company of America (SEAL)
Surety
tgt e
Jeffrey R. Gryde, Attorney -in -Fact
CBF -6
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,a7. )C) t)7 POWER
A rlutm i' OF ATTORNEY
No.
KNOW ALL BY THESE PRESENTS:
Solace Insurance Company of America
General Insurance Company of America
1001 4th Avenue
Suite 1700
Seattle, WA 98154
9392
That SAFECO INSURANCE COMPANY OF AMERICA and GENERAL INSURANCE COMPANY OF AMERICA, each a
Washington corporation, does each hereby appoint
*•" *" ** * * "' " " " * "* " * * * . """* ""' "JEFFREY R. GRYDE, Laguna Niguel, California * " "x - x' *' ......., x .. « : .. x ..
its true and lawful attomey(s) -in -fact, with full authority to execute on its behalf fidelity and surety bonds or undertakings and other
documents of a similar character issued in the course of its business, and to bind the respective company thereby.
IN WITNESS WHEREOF, SAFECO INSURANCE COMPANY OF AMERICA and GENERAL INSURANCE COMPANY OF
AMERICA have each executed and attested these presents
this
21st March 2009
day of —
Dexter R Legg Secretary Timothy A. Mikolaiewskf, Visa President
CERTIFICATE
Extract from the By -Laws of SAFECO INSURANCE COMPANY OF AMERICA
and of GENERAL INSURANCE COMPANY OF AMERICA:
"Article V, Section 13. - FIDELITY AND SURETY BONDS ... the President, any Vice President, the Secretary, and any Assistant Vice
President appointed for that purpose by the officer in charge of surety operations, shall each have authority to appoint individuals as
attomeys -in -fact or under other appropriate titles with authority to execute on behalf of the company fidelity and surety bonds and
other documents of similar character issued by the company in the course of its business... On any instrument making or evidencing
Such appointment, the signatures may be affixed by facsimile. On any instrument conferring such authority or on any bond or
undertaking of the company, the seal, or a facsimile thereof, may be impressed or affixed or in any other manner reproduced;
provided, however, that the seal shall not be necessary to the validity of any such Instrument or undertaking.'
Extract from a Resolution of the Board of Directors of SAFECO INSURANCE COMPANY OF AMERICA
and of GENERAL INSURANCE COMPANY OF AMERICA adopted July 28, 1970.
"On any certificate executed by the Secretary or an assistant secretary of the Company setting out,
l) The provisions of Article V, Section 13 of the By -Laws, and
00 A copy of the power- of- attoney appointment, executed pursuant thereto, and
(iii) Certifying that said power • of - attorney appointment is in full force and effect,
the signature of the certifying officer may be by facsimile, and the seat of the Company may be a facsimile thereof."
L Dexter R. Legg , Secretary of SAFECO INSURANCE COMPANY OF AMERICA and of GENERAL INSURANCE COMPANY
OF AMERICA, do hereby certify that the foregoing extracts of the By -Laws and of a Resolution of the Board of Directors of these
corporations, and of a Power of Attorney issued pursuant thereto, are true and correct, and that both the By -Laws, the Resolution and the
Power of Attorney are still in full force and effect,
IN WITNESS WHEREOF, I have hereunto set my hand and affixed the facsimile seal of said corporation
this 6th day of September 2011
CQi�t#tATE �
SEALXi
Gy, � y Dexter R. Legg, Secretary
5- 0974(DS 3109 WEB PDF
CALIFORNIA CERTIFICATE OF ACKNOWLEDGMENT
State of California
County of Orange
On September 6 , 2011 before me, Patti Zeis Notary Public, personally appeared Jeffrey R. Gryde
Who proved to me on the basis of satisfactory evidence to be the person whose name is subscribed
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.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
ADDITIONAL OPTIONAL INFORMATION
DESCRIPTION OF THE ATTACHED DOCUMENT
(Title ar deseripiipn ofatWChed tk+cumentl
fl ide or daacriplion of attached docosnent continued)
Number of Pages Document Date
(Additiomal information)
CAPACITY CLAIMED BY THE SIGNER
CJ
Individual (s)
D
Corporate Ofltecr
(Title)
C7
Partner($)
®
Attorney -in -Fact
❑
Trustee(s)
❑
Other
INSTRUCTIONS FOR COMPLETING THIS FORM
Asp nnt'now!¢dgnrern completed in Calafornla must contain verbiage exardy as
appears abow in the rroea!y section or a separate aehnowleAment fwm must be
property completed and aaacAed to drat document. The only exceprion is If a
document is to be recorded onside of California- In such twamcer, ant attemariee
acknowledgment werbinge as may be primed on such a documtmi so long as the
verhiage dot's not require the notary fo do somelhing Thar is 1Rtgaf fw a neon• in
Gr7lfortu (ie, terrifying the audaarized capaclty of file signer)- Please rheck the
document carrfnrty for proper swmritn' wnrding and attach (his form ifrequired.
• State and County infarrratian must be the Slate and Coady where the docmnem
signcr(s) personally appeared before the noteny public ku acknowledgment.
• Dale of maarrtalina mast be the date. that the sigucr(s) personally appeared which
must also be the same date the aekmowledgrnmi is completed.
• The notary public must print his or ber name as it appears within his or her
coanniecion followed by a comma and then your title (notary public).
• Prim the aame(s) of document signcris) who peranratly appeor at the time of
notariantiom
• Indicate Inc omrtet aingaher or plural tomes by crossing off inconecl forma (i.e.
Ma'alre/dsoyr- is An ) or circling the coricel forau. Failum to cuneetiy indicatr this
mfamation pray Iced to 'ejection of dueumsnl rtearding-
• The notary scat impression must be clear and photographically rcprs dacible
Impression [test am coon rent of lines. if send impression snudges, re-ml if a
sumciem area pentuts, odterwise complete a different ackntrwledi mem form.
• Signature of the notary public mint match the signature on file with the office or
the Count% clerk.
'v Addinkmral information is not required but cuuW help in insane this
acknowledgment is not misowd or anachrd to a different docmncat.
Indicate title or type ofan ached document, number of pages and date,
0 Indicate the capucily claimed by the signer. If the claimed capacity is a
corptnate officer, indicate the title (i.e. CEO, CF'0. Srcrctary).
e Securely attach ibis doca nxm to the signed document
WITNESS my hand and official seal. t• PATTI ZEIS
COMM. # 1796537
^®.. NOTARY PUBL C • CALIFORNIA Q
ORANGE COUNTY O
r + iroao� COMM. EXPIRES APRIL 29, 2012 1