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<br />. <br /> <br />. <br /> <br />COUNTY OF ORANGE <br /> <br />By: <br /> <br />Chair, Board of Supervisors <br /> <br />Signed and certified that a copy of this <br />Document has been delivered to the <br />Chair of the Board <br /> <br />Dated: . <br /> <br />DARLENE J. BLOOM <br />Clerk of the Board of Supervisors of <br />Orange County, California <br /> <br />STATE OF CALIFOR.NIA ) <br />) SS <br />COUNTY OF ORA.NGE ) <br /> <br />ACKNOWLEDGEMENT <br /> <br />On , 2002 before me, <br />a Notary Public in and for said County and State, personally appeared <br /> <br />personally known to me (or proved to me on the basis of satisfactory evidence) to be the person <br />whose name is subscribed to the within instrument and acknowledged to me that she executed <br />the same in her authorized capacity, and that by her signature on the instrument the person, or the <br />entity upon behalf of which the person acted, executed the instrument. <br /> <br />'-. <br /> <br />WITNESS my hand and official seal. <br /> <br />Signature <br /> <br /> <br />Approved as to form: <br />Office of County Counsel. <br />Orange C01j1ty, Califoni~ <br /> <br />," I <br /> <br />Legal Description reviewed and approved by <br />CEO/Real Estate <br /> <br />ttti <br /> <br /> <br />~ ,- <br />J '" <br /> <br />'J <br /> <br />"'..... d<al <br /> <br />Dca:mber It). 2001 <br /> <br />Page 3 of 4 <br />