BUNU NU. PB03010409024
PREMIUM $2,122.00
FAITHFUL PERFORMANCE BOND
WHEREAS, the City Council of the City of Huntington Beach, Stale of California, and Olson Urban V - Huntington Beach 4, LLC
(hereinafter designated as "principal") have entered into an agreement whereby principal agrees to install and complete designated public improvements, which said agreement, dated. 20_ and identied as project TR 19157/Talbert_, is hereby referred to and made a part heret; and WHEREAS, said principal is required under the terms of said agreement to furnish a bond for the faithful performance of said agreement.
Now, therefor, we, the principal and Philadelphia Indemnity Insurance Company as surely, are held and firmly bound unto the City of Huntington Beach, hereinafter called "City", the penal sum of_Four Hundred Twenty Four Thousand Four Hundred Seventy One and 30/00 dollars (S 424.471.30 lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, successors, executors and administrators, jointly and severally, firmly by these presents.
The condition of this obligation is such that if the above bounded principal, his or its heirs, executors, administrators, successors or assigns, shall in all things stand to and abide by, and well and truly keep and perform the covenant, condition and provisions in the said agreement and any alteration thereof made as therein provided, on his or their part, to be kept and performed at the time and in the manner therein specified, and in all respects according to their true intent and meaning, and shall indemnity and save harmless "City", its officers, agents and employees, a therein stipulated, then this obligation shall become null and void; otherwise it shall be and remain in full force and effect. •As a part of the obligation secured hereby and in addition to the face amount specified therefor, 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.
FAITHFULL PERFORMANCE BOND FM doc
The surety hereby stipulates and agrees that no charge, extension of time, alteration or addition to the terms of the agreement or to the work to be performed thereunder or the specifications accompanying the same shall in anywise affect its obligations on this bond, and it does hereby waive notice of any change, extension of time, alteration or addition to the terms of the agreement or to the work or to the specifications.
in witness whereof, this instrument has been duly executed by the principal and surety above named, on October 26 _, 20 22
Olson Urban V - Huntington Beach 4, LLC _ as Principal
By See Attached signature page
By
Philadelphia l Insurance Company
By Martha Barreras, Attorney-In-Fact
APPROVED AS TO FORM
BV: MICHAEL E. GATES
CITY ATTORNEY
CITY OF HUNTINGTON BEACH
FAITHFULL PERFORMANCE BOND EM. doc
ALL- PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
State of California
County of Orange - 1
OCT 2 6 2022
before me, _ Gina L. Garner, Notary Public
On_
(Here insert name and tile of the officer)
personally appeared Martha Barreras
who proved to me on the basis of satisfactory evidence to be the personed whose name(s) is/axe subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacityiesk and that by *is/her/txaix 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.
GINA L. GARNER
Notary Public - California
WITNESS my hand and official seal. Orange County
Commission # 2361777
Millam My Comm. Expires Jun 18, 2025
Notary Public Signature (Notary Public Seal)
INSTRUCTIONS FOR COMPLETING THIS FORM
ADDITIONAL OPTIONAL INFORMATION This form complies with current California statutes regarding notary wording and, DESCRIPTION OF THE ATTACHED DOCUMENT if needed, should be completed and attached to the document. Acknohredgents from other states may be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notary lar. (Title or description of attached document) • State and County information must be the State and County where the document signers) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signers) personally appeared which (Tite or description of attached document continued) must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her Number of Pages . Document Date, commission followed by a comme and then your title (notary publie). • Print the name(s) of document signer(s) who personally appear at the time of notarization.
CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. he/she/they, is /ere ) or circling the correct forms. Failure to correctly indicate this • Individual (s) information may lead to rejection of document recording. • Corporate Office • The notary seal impression must be clear and photographically reproducible.
Impression must not cover text or lines. If seal impression smudges, re-seal if a (Title) sufficient area pennits, otherwise complete a different acknowledginent form. • Signature of the notary public must match the signature on file with the office of • Partners) the county clerk.
• Attorney-in-Fact Additional information is not required but could help to ensure this • Trustee(s) acknowledgment is not misused or attached to a different document. * Indicate title or type of attached document, number of pages and date. • Other. Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). 2015 Version www.NotaryClasses.com 800-873-9565 • Securely attach this document to the signed document with a staple.
PHILADELPHIA INDEMNITY INSURANCE COMPANY
One Bala Plaza, Suite 100
Bala Cynwyd, PA 19004-0950
Power of Attorney
KNOW ALL PERSONS BY THESE PRESENTS: That PHILADELPHIA INDEMNITY INSURANCE COMPANY (the Company, a corporation organized and his Power of Attorney is granted and is signed and scaled by facsimile under and by the authority of the following Resolution adopted by the Board of Directors o HIILADELPHIA INDEMNITY INSURANCE COMPANY on the 14ª of November. 201 RESOLVED: That the Board of Directors hereby authorizes the President or any Vice President of the Company: (1) Appoint Attomey(s) in Fact and authorize the Attomey(s) in Fact to execute on behalf of the Company bonds and undertakings, contracts of indemnity and other writings obligatory in the nature thereof and to attach the seal of the Company thereto; and (2) to remove, at any time, any such Attomey-in-Fact and revoke the authority given. And,
FURTHER
RESOLVED: That the siguatures of such officers and the seal of the Company may be affixed to any such Power of Attorney or certificate relating thereto by faosimile, and any such Power of Antoine pa in any by etie entire and a band a hal being ide which it is attached.
IN TESTIMONY WHEREOF, PHILADELPHIA INDEMNITY INSURANCE COMPANY HAS CAUSED THIS INSTRUMENT TO BE SIGNED AND ITS CORPORATE SEALTO BE AFFIXED BY ITS AUTHORIZED OFFICE THIS STH DAY OF MARCH. 2021. 1927
Sal With.
(Scal)
Philadelphia Indemnity Insurance Company
On this 5* day of March, 2021 before me came the individual who excouted the preveding instrument, to me personally known, and being by me duly sworn said that he is the therein described and authorized officer of the PHILADELPHIA INDEMNITY INSURANCE COMPANY; that the seal affixed to said instrument is the Corporate seal of said Company; that the said Corporate Seal and his signature were duly affixed.
Notary Public:
commonwealth of Pennsylvania - Notary Sei Vancose Mckengee anessa Mckenzie, Notary Publi
Montgomery County
My commission expires November 3, 2024
Commission number 1366394
Member. Pannsylva". a Association of Notaries Bala Cynivyd, PA residing at:
My commission espires: November 3, 2024
in Glomb, who executed the Power of Attorey as President, was on the date of execution of the attached Power of Attorcy the duly clooted President
IILADELPHIA INDEMNITY INSURANCE COMPAN
In Testimony Whereof I have subscribed my name and affixed the facsimile seal of each Company this 26th _day of October _ 2022 ElSa
1927 FATA SEY FINDENTY INSURANCE COMPANY
THE Signature Block -
Olson Urban V - HUNTINGTON BEACH 4, LLC
OFFICIAL SIGNATURE BLOCK FORMAT:
OLSON URBAN V - HUNTINGTON BEACH 4, LLC
a Delaware limited liability company
By: OLSON URBAN COMMUNITIES V, LLC
a Delaware limited liability company
Sole Member
By: OLSON URBAN VENTURES V, LLC
Sole Mean limited liability company
By: OLSON URBAN HOUSING, LLC
operatinare limited liabity company
By: IN TOWN LIVING, INC.
a Delaware corporatior
Managing Member
By Thouras Moou
Nate: Senior Mresident, Operational Planning
Q: Corporate|Legal Entities|Huntington Beach 41Formation Documents ExCyl1 - Signature Block Olson Urban V (with OUC V) - Huntington Beach 4 DRAFT.docx
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
SS
COUNTY OF ORANGE
On November 7, 2022 before me, N. Steinkellner, Notary Public, personally appeared William E. Holford & Thomas Moore who proved to me on the basis of satisfactory evidence to be the person(s) whose names) 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.
WITNESS my hand and official seal.
N. STEINKELLNER Aleitellner
Notary Public - California
Orange County Notary Public
Commission # 2349954
My Comm. Expires Mar 3, 2025 State of California
(SEAL)
BOND NO. PB03010409024
PREMIUM included in performance bond
LABOR AND MATERIAL BOND
WHEREAS, the City Council of the City of Huntington Beach, State of California, and Olson Utban V - Huntington Beach 4 LLC
(hereinafter designated as "Principal") have entered into an agreement whereby principal agrees to install and complete designated public improvements, which said agreement, dated 20_ and identified as project Tract 19157/ Tallert _ is hereby referred to and made a part hereof; and
WHEREAS, under the terms of said agreement, principal is required before entering upon the performance of the work, to file a good and sufficient payment bond with the City of Huntington Beach to secure the claims to which reference is made in Title 15 (commencing with Section 3082) of Part 4 of Division 3 of Civil Code of the State of California.
Now, therefore, said Principal and the undersigned as corporate surety, are held firmly bound unto the City of Huntington Beach and all contractors, subcontractors, laborers, materialmen and other persons employed in the performance of the aforesaid agreement and referred to in the aforesaid Civil Code in the sum of Twa Hundred tweive Thousand Two Hundred Thity Ave and 65100 dollars 5 212,235.6 _, for materials furnished for labor thereon of any kind, or for amounts due under the Unemployment Insurance Act with respect to such work or labor, that said surety will pay the same in an amount not exceeding the amount hereinabove set forth, and also in case suit is brought upon this bond, will pay, in addition to the face amount thereof, costs and reasonable expenses and fees, including reasonable attorney's fees, incurred by "City" in successfully enforcing such obligation, to be awarded and fixed by the court, and to be taxed as costs and to be included in the judgment therein rendered.
It is hereby expressly stipulated and agreed that this bond shall insure to the benefit of any and all persons, companies and corporations entitled to file claims under Title 15 (commencing with Section 3082) of Part 4 of Division 3 of the Civil Code, so as to give a right of action to them or their assigns in any suit brought upon this bond.
Should the condition of this bond be fully performed, then this obligation shall become null and void, otherwise it shall be and remain in full force and effect.
The surety hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of said agreement or the specifications accompanying the same shall in any manner affect its obligation on this bond, and it does hereby waive notice of any such change, extension, alteration or addition.
in witness whereof, this instrument has been fully executed by the principal and surely above named, on October 26 _ 20 22
Olson Urban V - Huntington Beach 4, LLC _ as Principal
By See attached signature page
By -
- as Surety
smera
By Martha Barreras, Attorney-In-Fact
APPROVED AS TO FORM
BY: MICHAEL E GATES
CITY ATTORNEY
CITY OF HUNTINGTON BEACH
2 ALL- PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
A notary public or other officer completing this certificate verifies only the is atached, and not the truthtunes, accuracy, or vatity of that document.
State of California
County of Orange - 1
OCT 2 6 2022before me, _ Gina L. Garner, Notary Public
personally appeared Martha Barreras
who proved to me on the basis of satisfactory evidence to be the personger whose name(s) is/axe subscribed to the within instrument and acknowledged to me that he/she/they executed the same in kis/her/their authorized capacity(ies) and that by kis/her/tex 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.
GINA L. GARNER
WITNESS my hand and official seal. Notary Public • California Orange County
Commission # 2361777
My Comm. Expires Jun 18,2025
Notary Public Signature (Notary Public Seal)
INSTRUCTIONS FOR COMPLETING THIS FORM
ADDITIONAL OPTIONAL INFORMATION
This form complies with current California statutes regarding notary wording and.
DESCRIPTION OF THE ATTACHED DOCUMENT if needed, should be completed and attached 1o the document. Acknoledgents from other states may be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notary lar. (Tille or description of attached document) • State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signers) personally appeared which (Title or description of attached document continued) must also be the same date the acknowledginent is completed. • The notary public must print his or her name as it appears within his or her Number of Pages _ Document Date. commission followed by a comma and then your title (notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization.
CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. he/shc/they, is /are) or circling the correct forms. Failure to correctly indicate this • Individual (s) information may lead to rejection of document recording.
Corporate Officer • The notary seal impression must be clear and photographically reproducible.
Impression must not cover text or lines. If seal impression smudges, re-seal if a (Title) sufficient area pennits, otherwise complete a different acknowledgment forn.
Partners) • Signature of the notary public must match the signature on file with the office of the county clerk.
• Attorney-in-Fact Additional information is not required but could help to ensure this • Trustee(s) acknowledgment is not misused or attached to a different document. * Indicate title or type of attached document, number of pages and date.
Other. * Indicate the capacity claimed by the signer. If the claimed capacity is a corporate officer, indicate the title (i.e. CEO, CFO, Secretary). 2015 Version www.NotaryClasses.com 800-873-9565 • Securely attach this document to the signed document with a staple.
PHILADELPHIA INDEMNITY INSURANCE COMPANY
One Bala Plaza, Suite 100
Bala Cyawyd, PA 19004-0950
Power of Attorney
KNOW ALL PERSONS BY THESE PRESENTS: That PHILADELPHIA INDEMNITY INSURANCE COMPANY (the Company), a corporation organized and existing under the laws of the Commonwealth of Pennsylvania, does hereby constitute and appoint JANINA MONROE, THOMAS G. MCCALL, TIMOTHY J.
NOONAN, MICHELLE HAASE, MARTHA BARRERAS AND RACHEL A. MULLEN OF LOCKTON COMPANIES, LLC, its true and lawful Attorney-in- fact with full authority to execute on its behalf bonds, undertakings, rocognizances and other contracts of indemnity and writings obligatory in the nature thereof, issued in the course of its business and to bind the Company thereby, in an amount not to exceed $50.000.000.
This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Direotors of PHILADELPHIA INDEMNITY INSURANCE COMPANY on the 14* of November. 2016.
RESOLVED:
writings obligatory in the nature thereof and to attach the seal of the Company thereto; and (2) to remove, at any time, any such Attorney-in-Fact and revoke the authority given. And be it
FURTHER
RESOLVED: That the signatures of such officers and the seal of the Company may be affixed to any such Power of Attorney or certificate relating thereto by facsimile, and any such Power of which it is attached
N TESTIMONY WHEREOF, PHILADELPHIA INDEMNITY INSURANCE COMPANY HAS CAUSED THIS INSTRUMENT TO BE SIGNED AND ITS CORPORATE SEALTO BE AFFIXED BY ITS AUTHORIZED OFFICE THIS 5TH DAY OF MARCH, 2021. 1927
Sal With.
(Seal)
Glomb, President & CEO
Philadelphia Indemnity Insurance Company
On this 5ü day of March, 2021 before me came the individual who executed the preceding instrument, to me personally known, and being by me duly sworn said that ho is the therein described and authorized officer of the PHILADELPHIA INDEMNITY INSURANCE COMPANY; that the seal affixed to said instrument is the Corporate seal of said Company; that the said Corporate Seal and his siguature were duly affixed.
Notary Public:
Varias Mckenzie
Montgomery County
My commission expires November 3, 2024
Commission number 1366394
Member, Panngyiva".4 Association of Nolaries
residing at: Bala Cynwyd, PA
My commission expires: November 3, 2024
In Testimony Whereof I have subscribed my name and affixed the facsimile seal of each Company this 26th day of October 2022 19;
AILA SELLO, AND NOT INSURANCE COMPANY
THE Signature Block -
Olson Urban V - HUNTINGTON BEACH 4, LLC
OFFICIAL SIGNATURE BLOCK FORMAT:
By: OLSON URBAN COMMUNITIES V, LLC
a Delaware limited liability company
Sole Member
By: OLSON URBAN VENTURES V, LLC
a Delaware limited liability company
Sole Member
By: OLSON URBAN HOUSING, LLC
a Delaware limited liability company
Operating Member
By: IN TOWN LIVING, INC.
a Delaware corporation
Managing Member
By:_
Name: William E. Holford
Title: Senior Vice President, President, Olson Communities By. Thomas moon
Name: Thomas Moore
Title: Senior Vice President, Operational Planning
Q: Corporate|Legal Entities Huntington Beach 4/Formation Documents ExCyl1 - Signature Block Olson Urban V (with OUC V) - Huntington Beach 4 DRAFT.docx
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 ORANGE
On November 7, 2022 before me, N. Steinkellner, Notary Public, personally appeared William E. Holford & Thomas Moore who proved to me on the basis of satisfactory evidence to be the person(s) whose names) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacityies), 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.
WITNESS my hand and official seal.
N. STEINKELLNER Blankeller
Notary Public - California
Orange County Notary Public
Commission # 2349954
My Comm. Expires Mar 3, 2025 State of California
(SEAL)
MONUMENT BOND
KNOW ALL MEN BY THESE PRESENTS:
THAT _Olson Urban V - Huntington Beach 4, LLC
as Subdivider of Tract No. 19157 _ in the City of Huntington Beach, County of Orange, State of California, has submitted to said City a Final Map of said tract containing an engineer's or surveyor's certificate stating that all final monuments will be set in the positions indicated on or before the date specified in said certificate:
That said Olson Urban V - Huntington Beach 4, LLC
(Subdivider)
as principal, and Philadelphia indemnity insurance Company as surety, hereby guarantee to the City of Huntington Beach the payment of the cost of setting all such monuments within or in connection with said tract, as are not already set prior to the recording of said Final Map, in accordance with said map and said certificate up to but not in excess of the sum of $3.500.00 _ in which sum we are held and firmly bound to the City of Huntington Beach, all in accordance with and subject to the terms, conditions and provisions of Article 9, Chapter 4 of the Government Code of the State of California.
IN WITNESS WHEREOF, we have executed this instrument this_1st _ day of November _ 2022
Olson Urban V - Huntington Beach 4, LLC
→ as Principal
By See attached signature page
By
_Philade phia Inderhity insurance Company _, as Surety
By LY Amera
By Martha Barreras, Attorney-In-Fact 1927
1 PHILADELPHIA INDEMNITY INSURANCE COMPANY
One Bala Plaza, Suite 100
Bala Cymwyd, PA 19004-0950
Power of Attorney
KNOW ALL PERSONS BY THESE PRESENTS: That PHILADELPHIA INDEMNITY INSURANCE COMPANY (the Company), a corporation organized and existing under the laws of the Commonwealth of Pennsylvania, does hereby constitute and appoint JANINA MONROE, THOMAS G. MCCALL, TIMOTHY J. fact with full authority to execute on its behalf bonds, undertakings, recognizances and other contracts of indemnity and writings obligatory in the nature thereof, issued NOONAN, MICHELLE HAASE, MARTHA BARRERAS AND RACHEL A. MULLEN OF LOCKTON COMPANIES, LLC, its true and lawful Attomey-in- in the course of its business and to bind the Company thereby, in an amount not to exceed $50.000,000.
PHILADELPHIA INDEMNITY INSURANCE COMPANY on the 14* of November, 2016. This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of RESOLVED:
That the Board of Directors hereby authorizes the President or any Vice President of the Company: (1) Appoint Attomey(s) in Fact and authorize the Attomey(s) in Fact to execute on behalf of the Company bonds and undertakings, contracts of indemnity and other wifings obligatory in the nature thereof and to attach the seal of the Company thereto; and (2) to remove, at any time, any such Attomey-in-Fact and revoke the authority given. And, be it
FURTHER
RESOLVED: That the signatures of such officers and the seal of the Company may be affixed to any such Power of Attorney or certificate relating thereto by facsimile, and any such Power of Attomey so executed and certified by facsimile signatures and facsimile seal shall be valid which it is attached. and binding upon the Company in the future with respect to any bond or undertaking to CORPORATE SEALTO BE AFFIXED BY ITS AUTHORIZED OFFICE THIS STH DAY OF MARCH, 2021. IN TESTIMONY WHEREOF, PHILADELPHIA INDEMNITY INSURANCE COMPANY HAS CAUSED THIS INSTRUMENT TO BE SIGNED AND ITS (Scal)
Philadelphia Indemnity insurance Company
is the therein described and authorized officer of the PHILADELPHIA INDEMNITY INSURANCE COMPANY: that the seal affixed to said instrument is the On this s" day of March, 2021 before me came the individual who executed the preceding instrument, to me personally known, and being by me duly sworn said that he Corporate seal of said Company; that the said Corporate Seal and his signature were duly affixed.
Notary Public:
Commonwealth of Pennsylvania - Notary Seal Vaness McKenzie Venessa Mckenzie, Notary Public
Montgomery County
My commission expires November 3, 2024/
Commission number 1366394
Member, Pannsylvan: Association of Notaries
residing at: Bala Cynwyd, PA
My commission expires: November 3, 2024
I, Edward Sayago, Corporate Secretary of PHILADELPHIA INDEMNITY INSURANCE COMPANY, do hereby certify that the foregoing resolution of the Board of Directors and the Power of Attomey issued pursuant thereto on the 5* day March, 2021 are true and correct and are still in full force and effoct. 1 do further certify that PI. ADE, HANDEMN SURANCE COMPA President, was on the date of execution of the attached Power of Allomey the duly cleoted President of In Testimony Whereof I have subsoribed my name and affixed the facsimile seal of each Company this _ 1st _day of November 2022
1827 Edward Sayago, Corporate Secretary
PHILADELPRIA INDEMNITY INSURANCE COMPANY
ALL- PURPOSE
CERTIFICATE OF ACKNOWLEDGMENT
State of California }
County of Orange }
On NOV 01 2022 Gina L. Garner, Notary Public
before me,.
(Here insert name and title of the officer)
personally appeared Martha Barreras
who proved to me on the basis of satisfactory evidence to be the persons whose name(s) is/axe subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/teir authorized capacitypies), and that by kis/her/texix 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.
GINA L. GARNER
WITNESS my hand and official seal. Notary Public - California Orange County
Commission # 2361777
My Comm. Expires Jun 18, 2025
Notary Public Signature
(Notary Public Seal)
ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM DESCRIPTION OF THE ATTACHED DOCUMENT This form complies with current California statutes regarding notary wording and. if needed, should be completed and attached to the document. Acknoredgents from other states may be completed for documents being sent to that state so long as the wording does not require the California notary to violate California notary law. (Title or description of attached document)
• State and County information must be the State and County where the document signer(s) personally appeared before the notary public for acknowledgment. (Title or description of attached document continued) • Date of notarization must be the date that the signers) personally appeared which must also be the same date the acknowledgment is completed.
Number of Pages Document Date • The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). • Print the names) of document signers) who personally appear at the time of notarization.
CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms (i.e. • Individual (s) he/she/they, is /are) or circling the correct forms. Failure to correctly indicate this • Corporate Officer information may lead to rejection of document recording. • The notary seal impression must be clear and photographically reproducible. (Title) Impression must not cover text or lines. If seal impression smudges, re-scal if a sufficient area permits, otherwise complete a different acknowledgment form.
Partners) • Signature of the notary public must match the signature on file with the office of • Attorney-in-Fact the county clerk.
• Trustee(s) Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. • Other Indicate title or type of attached document, number of pages and date.
Indicate the capacity claimed by the signer. If the claimed capacity is a 2015 Version www.NotaryClasses.com 800-873-9865 corporate officer, indicate the title (i.e. CEO, CFO, Secretary). • Securely attach this document to the signed document with a staple.
STATE OF CALIFORNIA
) SS
COUNTY OF ORANGE
ON
_ BEFORE ME, _
NOTARY PUBLIC IN AND FOR SAID STATE, PERSONALLY APPEARED _ A OF SATISFACTORY EVIDENCE TO BE THE PERSONS WHOSE NAME(S) IS/ ARE _ PROVED TO ME ON THE BASIS
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
OF THE STATE OF CALIFORNIA THAT THE FOREGOING PARAGRAPH IS TRUE AND I CERTIFY UNDER PENALTY OF PERJURY UNDER THE LAWS CORRECT.
WITNESS MY HAND AND OFFICIAL SEAL.
SIGNATURE
SEAL
STATE OF CALIFORNIA 3 ss
COUNTY OF ORANGE
ON_ BEFORE ME,
NOTARY PUBLIC IN AND FOR SAID STATE, PERSONALLY APPEARED _ A OF SATISFACTORY EVIDENCE TO BE THE PERSONS WHOSE NAME(S) IS/ ARE _ PROVED TO ME ON THE BASIS
HE/SHE/THEY EXECUTED THE SAME IN HIS/HER/THEIR AUTHORIZED CAPACITY (IES), SUBSCRIBED TO THE WITHIN INSTRUMENT AND ACKNOWLEDGED TO ME THAT 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
OF THE STATE OF CALIFORNIA THAT THE FOREGOING PARAGRAPH IS TRUE AND I CERTIFY UNDER PENALTY OF PERJURY UNDER THE LAWS CORRECT.
WITNESS MY HAND AND OFFICIAL SEAL.
SIGNATURE_
SEAL
FAITHFULL PERFORMANCE BOND FM...dec
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
SS
COUNTY OF ORANGE
On November 7, 2022 before me, N. Steinkellner, Notary Public, personally appeared William E. Holford & Thomas Moore who proved to me on the basis of satisfactory evidence to be the person(s) whose names) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their of which the person(s) acted, executed the instrument. authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf is true and correct. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph WITNESS my hand and official seal.
N. STEINKELLNER
Notary Public - California stinteller
· Orange County
Commission # 2349954 Notary Public
My Comm. Expires Mar 3, 2025
(SEAL) State of California
THE
Signature Block -
10 SON CONTE Olson Urban V - HUNTINGTON BEACH 4, LLC
OFFICIAL SIGNATURE BLOCK FORMAT:
OLSON URBAN V - HUNTINGTON BEACH 4, LLC
a Delaware limited liability company
By: OLSON URBAN COMMUNITIES V, LLC
a Delaware limited liability company
Sole Member
By: OLSON URBAN VENTURES V, LLC
a Delaware limited liability company
Sole Member
By: OLSON URBAN HOUSING, LLC
a Delaware limited liability company
Operating Member
By: IN TOWN LIVING, INC.
a Delaware corporation
Managing Member
By:_
Name: William E. Holford
Title: Senior Vice President, President, Olson Communities By. Thomas Moone
Name: Thomas Moore
Title: Senior Vice President, Operational Planning
OUC V) - Huntington Beach 4 DRAFT.docx Q:\Corporate\Legal Entities|Huntington Beach 41Formation Documents ExCyl1 - Signature Block Olson Urban V (with