CITY OF
FAITHFUL PERFORMANCE BOND
MENIFEE CITY OF MENIFEE, STATE OF CALIFORNIA
(Government Code Section 66499.1)
FOR: Streets and Drainage $ Tract Map _TM38303
Riv. Co. Flood Control $ Other Project Ref. IP24-010U
Water System Bond No. BDTO500219024
Rec. Water Premium $2,168.00
Sewer System 542.000.00
Total $ 542.000.00
Surety Liberty Mutual Insurance Company Principal Minor Ranch LLC Address 175 Berkeley Street Address 3200 Park Center Drive, Suite 1000 City/State Boston, MA City/State Costa Mesa, California Zip code 02116 Zip 92626
Phone 617-357-9500 Phone (714) 427-6868
WHEREAS, the City Council of the City of Menifee, State of California, and Minor Ranch LLC, a Delaware Limited Liability Company _ (hereinafter designated as "principal") have entered into, or are about to enter into, the attached agreements) whereby principal agrees to install and complete the above designated public improvements relating to Menifee Valley, TM38303, Improvement Plan IP24-010U _ which agreements), dated is/are hereby referred to and made a part hereof; and,
WHEREAS, said principal is required under the terms of said agreements) to furnish bond(s) for the faithful performance of said agreements);
NOW, THEREFORE, we the principal and Liberty Mutual Insurance Company, as surety, are held and firmly bound unto the City of Menifee in the penal sum of Five Hundred Forty- Two Thousand--- - 00/100, Dollars, ($542,000.00) lawful money of the United States, for the payment of which sum will and truly 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 bonded 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 covenants, conditions and provisions in the said agreements) 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 indemnify and save harmless the City of Menifee, its officers, agents and employees, as therein stipulated, then this obligation shall become null and void; otherwise, it shall remain in full force and effect.
As a part of the obligation secured hereby and in addition to the face amount specified therefore, there shall be included costs and reasonable expenses and fees, including reasonable attorney's fees, incurred by the City of Menifee in successfully enforcing such obligation, all to be taxed as costs and included in any judgment rendered.
FAITHFUL PERFORMANCE BOND
The surety hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the agreements) or to the work to be performed thereunder or the specifications accompanying the same shall in anywise affect its obligation on this bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the agreements) or to the work or to the specifications..
Surety further stipulates and agrees that the provisions of Section 2845 of the Civil Code and commencement of construction are not conditions precedent to surety's obligations hereunder and are hereby waived by surety.
When the work covered by the agreements) is complete, the City of Menifee will accept the work and thereupon, the amount of the obligation of this bond is reduced by 90% with the remaining 10% held as security for the one-year maintenance period provided for in the agreements).
IN WITNESS WHEREOF, this instrument has been duly executed by the principal and surety above named, on 23d September, 2024.
NAME OF PRINCIPAL: Minor Ranch LLC
AUTHORIZED SIGNATURE(S):
By:
Name: John M. Ogren
Title: Vice President
(IF CORPORATION, AFFIX SEAL)
NAME OF SURETY: Liberty Mutual Insurance Company
AUTHORIZED SIGNATURE:
Tina McEwan, Attorney-in-Fact
(IF CORPORATION, AFFIX SEAL)
ATTACH NOTARIAL ACKNOWLEDGMENT OF SIGNATURES OF PRINCIPAL AND ATTORNEY-IN-FACT.
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 September 24. 2024 _ before me, S Six
John M Ogren _ who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they/ executed the same in his/her/their authorized capacity(ies) and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the 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.
A lix
Notary Public • California Notary Public
Orange County
Commission # 2421761
My Comm. Expires Oct 16, 2026
This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated.
Liberty Liberty Mutual Insurance Company
Mutual. The Ohio Casualty Insurance Company Certificate No: 8205467-022020 West American Insurance Company
SURETY
POWER OF ATTORNEY
KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, DonE.
Cornell; Joshua Saunders: Kelly A. Westbrook; Mikaela Peppers; Ricardo J. Reyna: Robbi Morales: Sophinie Hunter: Tina McEwan; Tonie Petranck all of the city of Dallas state of TX each individually if there be more than one named, its true and lawful attorney-in-fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons.
IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 23rd day of April 2021
Liberty Mutual Insurance Company
The Ohio Casualty Insurance Company
CORPORATE CORPORATE West American Insurance Company
1912 1919 1991
11430 OHIO ANTINOD ANTAND lait Cry
LSEM INDIANA
By:
guarantees. David M. Carey, Assistant Secretary
State of PENNSYLVANIA
County of MONTGOMERY SS ) verification inquiries,
On this 23rd day of April 2021 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance Company, The Ohio Casualty Company, and West American insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. loan, PASTELL (POA
TERESA Commonwealth of Pennsylvania - Notary Seal
interest rate or residual value Teresa Pastella, Nolary Public terras Pastella please call 610-832-8240 or email HOSUR @libertmutual.com Mongomery County
My commission expires March 28, 2025 By:
Commission number 1126044 Teresa Pastella, Notary Public TRANSY LATE Member, Pennsylvania Association of Notaries
NOTARY PUBIND
This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual Not valid for mortgage, note, Insurance Company, and West American Insurance Company which resolutions are now in full force and effect reading as follows: For bond and/or Power of Attorney ARTICLE IV - OFFICERS: Section 12. Power of Attorney.
Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the currency rate, President may prescribe, shall appoint such attorneys-in-fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys-in-fact, subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney-in-fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority.
ARTICLE XIII - Execution of Contracts: Section 5. Surety Bonds and Undertakings.
Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys-in-fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary.
Certificate of Designation - The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys-in- fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations.
Authorization - By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed.
1, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked.
23rd _ day or September. 2024
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seals of said Companies this
ANCE INSURANCE INSURANCE
«CORPORATE CASU ORPORATE (CORPORATE
1912 1919 1991 8
TO HAMPERE By:
ANTAMOD LSEM INDIANA ANTON Renee C. Llewellyn, Assistant Secretary THI
LMS-12873 LMIC OCIC WAIC Multi Co 02/21
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 995088059601565020230238602023023360202500000605666456216280256253/56450230 50/2862568162834830164795003956030/3000 2x02504562 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 Texas....
County of Dallas
on September aBid 202% before me, Tonie G. Petranek
Here Insert Name and Title of the Officer
personally appeared Tina McEwan
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the persons), 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 Texas that the foregoing paragraph
is true and correct.
WITNESS my hand and official seal.
TONIE G. PETRANEK
NOTARY PUBLIC Toni G Petron
STATE OF TEXAS Signature
MY COMM. EXP. 02/26/26 Tonie G. Petranek Signature of Notary Public AlE OF TE NOTARY ID 12610720-4
Place Notary Seal Above
- OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document: Document Date:
Number of Pages: Signers) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Signer's Name:
Corporate Officer - Title(s): 1 Corporate Officer - Title(s):
Partner - C Limited C General Partner - CJ Limited L General Individual (x Attorney in Fact Individual CJ Attorney in Fact Trustee C Guardian or Conservator Trustee • Guardian or Conservator Other: Other:
Signer Is Representing: Signer Is Representing:
©2014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907
CITY OF
MENIFEE: MATERIAL AND LABOR BOND
CITY OF MENIFEE, STATE OF CALIFORNIA
(Government Code Section 66499.2)
FOR: Streets and Drainage $. Tract/Parcel Map _TM38303
Riv. Co. Flood Control $ Other Proj. Ref. IP24-010U
Water System $ Bond No. BDTO500219024
Rec. Water $ Premium $2,168.00
Sewer System $. 271,000.00
Total $ 271,000.00
Surety Liberty Mutual Insurance Company Principal Minor Ranch LLC Address 175 Berkeley Street Address 3200 Park Center Drive, Suite 1000 City/State Boston, MA City/State Costa Mesa, California Zip 02116 Zip 92626
Phone 617-357-9500 Phone (714) 427-6868
WHEREAS, the City Council of the City of Menifee, State of California, and Minor Ranch LLC, a Delaware Limited Liability Company, (hereinafter designated as "principal") have entered into, or are about to enter into, the attached agreements) whereby principal agrees to install and complete the above designated public improvements relating to Menifee Valley, TM38303, Improvement Plan IP24-010U, which agreements), dated is/are hereby referred to and made a part hereof; and,
WHEREAS, under the terms of said agreements), principal is required, before entering upon the performance of the work, to file a good and sufficient payment bond with the City of Menifee to secure the claims to which reference is made in Title 3 (commencing with Section 9000) of Part 6 of Division 4 of the Civil Code of the State of California; NOW, THEREFORE, said principal and the undersigned, as corporate surety, are firmly bound unto the City of Menifee and all contractors, subcontractors, laborers, material suppliers, and other persons employed in the performance of the agreements) and referred to Title 3 (commencing with Section 9000) of Part 6 of Division 4 of the Civil Code in the sum of Two Hundred Seventy-One Thousand----- -... 00/100, Dollars, ($271,000.00) for materials furnished or 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 the City of Menifee 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 upon that this bond shall inure to the benefit of any and all persons, companies and corporations entitled to file claims under Title 3 (commencing with Section 9000) of Part 6 of Division 4 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.
MATERIAL AND LABOR BOND
The surety hereby stipulates and agrees that no change, extension of time, alteration, or addition to the terms of the agreements) or to the specifications accompanying the same shall in anywise affect its obligation on this bond, and it does hereby waive notice of any such change, extension of time, alteration, or addition.
Surety further stipulates and agrees that the provisions of Section 2845 of the Civil Code are not a condition precedent to surety's obligations hereunder and are hereby waived by surety.
IN WITNESS WHEREOF, this instrument has been duly executed by the principal and surety above named, on 23rd September, 2024.
NAME OF PRINCIPAL: Minor Ranch LLC
AUTHORIZED SIGNATURE(S):
By: John M. Ogren
Name:
Title: Vice President
(IF CORPORATION, AFFIX SEAL)
NAME OF SURETY: Liberty Mutual Insurance Company
AUTHORIZED SIGNATURE:
Tina McEwan, Attorney-in-Fact
(IF CORPORATION, AFFIX SEAL)
ATTACH NOTARIAL ACKNOWLEDGMENT OF SIGNATURES OF PRINCIPAL AND ATTORNEY-IN-FACT.
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
September 24. 2024 before me, _
John M Ogren who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) isfare subscribed to the within instrument and acknowledged to me tha 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.
I dix
Notary Public - California
Orange County Notary Public
Commission: 2421761
My Comm. Expires Oct 16, 2026
This Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated.
Liberty Liberty Mutual Insurance Company
Mutual. The Ohio Casualty Insurance Company Certificate No: 8205467-022020 West American Insurance Company
SURETY
POWER OF ATTORNEY
KNOWN ALL PERSONS BY THESE PRESENTS: That The Ohio Casualty Insurance Company is a corporation duly organized under the laws of the State of New Hampshire, that Liberty Mutual Insurance Company is a corporation duly organized under the laws of the State of Massachusetts, and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana herein collectively called the "Companies"), pursuant to and by authority herein set forth, does hereby name, constitute and appoint, Don E.
Cornell: Joshua Saunders: Kelly A. Westbrook; Mikaela Peppers: Ricardo J. Reyna: Robbi Morales; Sophinie Hunter: Tina McEwan; Tonie Petranck each individually if there be more than one named, its true and lawful attorney-in-fact to make, execute, seal, acknowledge and deliver, for and on its behalf as surety and as its act and deed, any and all undertakings, bonds, recognizances and other surety obligations, in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons.
IN WITNESS WHEREOF, this Power of Attorney has been subscribed by an authorized officer or official of the Companies and the corporate seals of the Companies have been affixed thereto this 23rd day of April 2021
Liberty Mutual Insurance Company
The Ohio Casualty Insurance Company
TUAL INSURANCE INSURANCE
CORPORA ORPORAT •CORPORATE West American Insurance Company 1912 1919 1991
OHIO ANYMOR Sait any
INDIANA inquiries,
*SAM By:
guarantees David M. Carey, Assistant Secretary
State of PENNSYLVANIA
County of MONTGOMERY S
On this 23rd day of April 2021 before me personally appeared David M. Carey, who acknowledged himself to be the Assistant Secretary of Liberty Mutual Insurance verification Company, The Ohio Casualty Company, and West American Insurance Company, and that he, as such, being authorized so to do, execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer.
IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my notarial seal at King of Prussia, Pennsylvania, on the day and year first above written. (POA) Commonwealth of Pennsylvania - Notary Seal
interest rate or residual value TERRE Teresa Pastella, Notary Public Pastello •lease call 610-832-8240 or email HOSUR @libertvmutual.com Montgomery County
My commission expires March 28, 2025 By:
Not valid for mortgage, note, loan, letter of credit, Commission number 1126044 Teresa Pastella, Notary Public
Member, Pennsylvania Association of Notaries
This Power of Attorney is made and executed pursuant to and by authority of the following By-laws and Authorizations of The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American insurance Company which resolutions are now in full force and effect reading as follows: -or bond and/or Power of Attornev ARTICLE IV - OFFICERS: Section 12, Power of Attorney.
Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President, and subject to such limitation as the Chairman or the currency rate, President may prescribe, shall appoint such attorneys-in-fact, as may be necessary to act in behalf of the Corporation to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys-in-fact, subject to the limitations set forth in their respective powers of attorney, shal have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation. When so executed, such instruments shall be as binding as if signed by the President and attested to by the Secretary. Any power or authority granted to any representative or attorney-in-fact under the provisions of this article may be revoked at any time by the Board, the Chairman, the President or by the officer or officers granting such power or authority.
ARTICLE XIII - Execution of Contracts: Section 5. Surety Bonds and Undertakings.
Any officer of the Company authorized for that purpose in writing by the chairman or the president, and subject to such limitations as the chairman or the president may prescribe, shall appoint such attorneys-in-fact, as may be necessary to act in behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations. Such attorneys-in-fact subject to the limitations set forth in their respective powers of attorney, shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company. When so executed such instruments shall be as binding as if signed by the president and attested by the secretary.
Certificate of Designation - The President of the Company, acting pursuant to the Bylaws of the Company, authorizes David M. Carey, Assistant Secretary to appoint such attorneys-in- fact as may be necessary to act on behalf of the Company to make, execute, seal, acknowledge and deliver as surety any and all undertakings, bonds, recognizances and other surety obligations.
Authorization - By unanimous consent of the Company's Board of Directors, the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company, wherever appearing upon a certified copy of any power of attorney issued by the Company in connection with surety bonds, shall be valid and binding upon the Company with the same force and effect as though manually affixed.
1, Renee C. Llewellyn, the undersigned, Assistant Secretary, The Ohio Casualty Insurance Company, Liberty Mutual Insurance Company, and West American Insurance Company do hereby certify that the original power of attorney of which the foregoing is a full, true and correct copy of the Power of Attorney executed by said Companies, is in full force and effect and has not been revoked.
IN TESTIMONY WHEREOF. I have hereunto set my hand and affixed the seals of said Companies this C Bid day of Septembr, 2024 «CORPORATE CORPORATE CAN • CORPORATE
1912 1919 1991
By:
ANTINO INDIANA INVO Renee C. Llewellyn, Assistant Secretary SHA
LMS-12873 LMIC OCIC WAIC Muttı Co 02/21
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.
State of Texas.....
County of Dallas )
on Septembr 23r el 2024 before me, Tonie G. Petranek
Date Here Insert Name and Title of the Officer
personally appeared Tina McEwan
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/ar ubscribed to the within instrument and acknowledged to me that he/she/they executed the same il 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 Texas that the foregoing paragraph
is true and correct.
WITNESS my hand and official seal.
TONIE G. PETRANEK
NOTARY PUBLIC toniCa Patrar
STATE OF TEXAS Signature
SIETE ORE MY COMM. EXP. 02/26/26 Tonie G. Petranek Signature of Notary Public NOTARY IB 12519720~4
Place Notary Seal Above
- OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an nintended document.
Description of Attached Document
Title or Type of Document: Document Date:
Number of Pages: Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name: Signer's Name:
: Corporate Officer - Title(s): 1 Corporate Officer - Title(s):
Partner - C Limited [ General : Partner - C Limited i General Individual ix Attorney in Fact Individual Li Attorney in Fact Trustee l. Guardian or Conservator Trustee C Guardian or Conservator Other: Other:
Signer Is Representing: Signer Is Representing:
©2014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907