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75J - PH - RESO NECESSITY 2209 S BRISTOL
REQUEST FOR COUNCIL ACTION CITY COUNCIL MEETING DATE: JUNE 20, 2017 TITLE: PUBLIC HEARING — RESOLUTION DETERMINING PUBLIC INTEREST AND NECESSITY FOR THE ACQUISITION OF REAL PROPERTY AT 2209 SOUTH BRISTOL STREET (PROJECT NO. 116741) (NONGENERAL FUND) (STRATEGICPLANNOS. 6, 1G; 3,2C) CI MANAGER RECOMMENDED ACTION CLERK OF COUNCIL USE ONLY: APPROVED ❑ As Recommended ❑ As Amended ❑ Ordinance on 15' Reading ❑ Ordinance on 2ntl Reading ❑ Implementing Resolution ❑ Set Public Hearing For CONTINUED TO FILE NUMBER Adopt a resolution authorizing the condemnation of the entire real property located at 2209 South Bristol Street (APN 015-194-25) declaring the public necessity and interest therefore. Bristol Street is a major north -south transportation facility which is designated as a major arterial highway in the City's Circulation Element of the General Plan. Improving the 3.9 -mile Bristol Street segment from Warner Avenue to Memory Lane has been a long-term priority project that is being constructed in several phases. Improvements include widening the street from two to three lanes in each direction, raised landscape medians, and bike lanes. Public Works Agency staff is acquiring properties for the development of Phase 4, bounded by Warner Avenue and Saint Andrew Place. Property acquisitions for this phase are expected to be completed by spring 2018, and construction is anticipated to begin in summer 2018. To accommodate the improvements and widening for Phase 4, acquisition of the parcel at 2209 South Bristol Street is required (Exhibit 1). The Public Works Agency has made a diligent effort to negotiate with the property owners and their representatives for the past 15 months. A good faith offer was made on January 30, 2017, in the amount of $568,025 (Exhibit 2). The Public Works Agency has made, and will continue to make, every effort to reach a settlement with the property owner. However, to maintain the Bristol Street Improvements project schedule and meet the funding requirement to commence construction in summer 2018, staff is requesting adoption of a Resolution of Necessity (Exhibit 3) and initiation of condemnation proceedings while negotiations continue. 75J-1 Public Hearing — Resolution Determining Public Interest and Necessity of Property at 2209 S. Bristol Street June 20, 2017 Page 2 STRATEGIC PLAN ALIGNMENT Approval of this item supports the City's efforts to meet Goal #6 — Community Facilities & Infrastructure, Objective #1 (establish and maintain a Community Investment Plan for all City assets), Strategy G (develop and implement the City's Capital Improvement Program in coordination with the Community Investment and Deferred Maintenance Plans). Approval of this item also supports the City's efforts to meet Goal #3 — Economic Development, Objective #2 (create new opportunities for business/job growth and encourage private development through new General Plan and Zoning Ordinance policies), Strategy C (support business development and job growth along transit corridors through the completion of critical transit plans/projects). ENVIRONMENTAL IMPACT In 1990, City Council approved the Bristol Street Final Environmental Impact Statement/Environmental Impact Report (FEIS/EIR No. 89-01). Due to several minor design modifications in Phase 4, which lies between Warner Avenue and St. Andrew Place, an Addendum to the FEIS/EIR was prepared and adopted pursuant to the California Environmental Quality Act by City Council on April 7, 2015. FISCAL IMPACT Funds in the amount of $568,025 are appropriated in the Bristol Street Improvements Project (No. 116741) for transfer to the State Treasurers Office Condemnation Deposits Fund in FY 2016-2017 from the following funds: $11,411 in the Select Street Construction Fund (Account No. 05917661 -66100), -and $556,614 in the Measure M2 Competitive Street Fund (Account No. 03217663-66100). Nit, I . �fL,� Fr Mousavip ur Executive Director Public Works Agency FM/EWG/JG/ML Exhibits: 1. Location Map 2. Offer Letter 3. Resolution of Necessity APPROVED AS TO FUNDS & ACCOUNTS: Francisco Gutierrez Executive Director Finance & Management Services Agency 75J-2 MATCHLINE SEE BELOW RIGHT I I I i I I I noaaao-n j ST GERTRUDE PL I Igoe-a'7,-o,� I 5 oil of Bao , o,a.lea.sa�: 01S -194.24I -•—••� b15 -W4.28: } i LEGEND: SUBJECT PROPLPT,' - FULL dCCUIb ITIOT1 -F.f-ONPLD PPOPEPTIF3 i _ I I ST ANDREW PL I I ITr _..+..+...� ; CARLTON PL I I .. L..l.._L.. d GLENWOOD PL I I j CAMDEN PL i i i e QST ANNE PL ISO r•-r--�---r-- I ryl i I I `i MATCHLINE SEE TOP LEFT SANTA ASIA RESOLUTION DETERMINING PUBLIC CITY COUNCIL INTEREST AND NECESSITY FW A AGENDA DATE; FOR THE ACOUISITION OF REAL --. JUNE 20, 2017 PROPERTY AT 2209 SOUTH BRISTOL STREET (PROJECT NO. 16741 NONGENERAL FUND) PUBLIC WORKS A09,KY (Strategic Plan No. 6, 1G, and 3, 2C) PAGE 1 OF 1 75J-3 City of Santa Ana RECEIPT OF OFFER PACKAGE Bristol Street Improvements —Warner Avenue to Saint Andrew Place Parcel File No. 015-194.25 Owner of Record: R & S Properties, LLC Additional Owner(s) of Record: N/A Property Address: 2209 S. Bristol Street, Santa Ana, CA 92704 This is to acknowledge receipt of the offer package containing the following items: Offer tetter dated January 30, 2017 which includes: • Fair Market Value of the Subject Property (Exhibit A) • Preliminary Report Issued by Title Company (Attachment 1) • Property Legal Description (Attachment 2) • Statement of Just Compensation (Attachment 3) • Summary Explanation Statement (Attachment 4) • City of Santa Ana Handbook on Acquisition (Attachment 5) • Statement of Ownership (Attachment 6) • List of Improvements (Attachment 7) • Your Rights Under Title VI (Attachment S) • W-9 Form (Attachment 9) Please return the SIGNED Receipt of Offer Package In the envelope enclosed. R & $ Properties, LLC By: Its: Date: EXHIBIT 2 75J-4 MAYOR Miguel A. Pulido MAYOR PRO TEM Michele Martinez COUNCILMEMBERS P. David Benavides Vicente Sarmiento Jose sotorlo Sal Tinajero Juan Villages January 30, 2017 R & S Properties, LLC 7606 Fallbrook Ave, Suite 13 West Hills, CA 91304-3610 CITY OF SANTA ANA 20 Civic Center Plaza • P.O. Box 1988 Santa Ana, California. 92702 714-847-5013 wm santa-ana-ora ACTING CITY MANAGER Gerardo Monet CITY ATTORNEY Sonia R. carvalho CLERK OF THE COUNCIL Maria D. Holzer Via Certified Mail SUBJECT: REVISED OFFER TO ACQUIRE PROPERTY AND IMPROVEMENTS PERTAINING TO REALTY AT: 2209 S. BRISTOL STREET; SANTA ANA; CA 92704 APN: 016.194-25 Dear Property Owner, This Offer supersedes all previous Offers to Acquire. The City of Santa Ana ("City") is proceeding with its plans to construct Phase 4 of the Bristol Street Improvements Project between Warner Avenue and Saint Andrew Place. The City obtained a preliminary title report that lists R & S Properties, LLC to be the vested owner of the above-mentioned property as shown in Attachment 1. The City seeks to acquire the property located at the above-mentioned address, which consists of the underlying real property as described in Attachment 2. The area to be acquired is referred to herein as the "Property", No final determination has been made as to the ownership of the Property. This offer is contingent upon presentation of conclusive evidence of title, if more than one person has an interest in the Property that the City is seeking to acquire, all parties with such interest must accept this offer. As you know; the City had your Property appraised by certified appraisers for the real estate as well as improvements pertaining to the realty to determine its fair market value. The appraisals were conducted in accordance with commonly accepted appraisal standards and included consideration of the highest and best use of the land. Based on the appraisals, the City offers you a total compensation of $568,025.00. The Fair Market Value of the Subject Property, which serves as the basis for this offer is attached as Exhibit A. This offer is conditional upon the City Council ratifying this offer by a formal action taken at a regular public meeting authorizing the execution of a Purchase and Sale Agreement or adopting a Resolution of Necessity, or both. 75J-5 2209 S. Bristol Street January 30, 2017 Page 2 If you are not satisfied with the City's offer, you are encouraged to present to us any material you believe to be relevant to the value of the Property, which material will be carefully considered by the City. If, in the City's opinion, the additional information warrants a change in the offer, the City's offer will be adjusted accordingly. If a voluntary agreement cannot be reached, the City may consider formal condemnation proceedings against the Property through its power of eminent domain or abandon its intention to acquire the Property, giving proper notice to you in either event. The City has made no decision to exercise its power of eminent domain to acquire the Property and can only do so after it holds a hearing, at which all affected Property owners have had an opportunity to appear and be heard. The Purchase Price is the full amount established by the appraisal as the fair market value of the Property and the just compensation for such acquisition. A written statement and a summary of the basis for the amount established as the Purchase Price is set forth in the attached Statement of Just Compensation, identified as Attachment 3. The City of Santa Ana Handbook on Acquisition provides that each Owner from whom the City purchases real property or an interest therein, or each tenant owning improvements on said Property, be provided with information relating to the acquisition procedures pursuant to the Government Code, Paragraph 7267.2(a). This information is provided in Attachment 5. Please also be advised that under Code of Civil Procedure Section 1263.025, the City of Santa Ana will reimburse an owner of property, up to the amount of $5,000 for the owner to secure an independent appraisal of property subject to a potential acquisition. Please let us know prior to March 2, 2017 if the City's offer is acceptable. A written agreement concerning the acquisition of the Property will be provided to you for your review and approval. It is the desire of the City to acquire private property through voluntary purchase, if possible. While the City has the power of eminent domain, condemnation has not yet been authorized with respect to your property, and no decision has yet been made to use the power of eminent domain to acquire your property. 75J-6 2209 S. Bristol Street January 30, 2017 Page 3 If for any reason you should see fit not to accept the City's offer, please be advised that this letter, the offer made herein, the enclosed summary statements, and all matters stated herein are made under the provisions of California Evidence Code §§1152 and 1154 and shall not be admissible in evidence in any eminent domain proceeding which may subsequently be instituted for acquisition of the Property, or in any other action. If you need additional information, please call City's acquisition consultant, Kathy Cabanilla from Epic Land Solutions, Inc. at (310) 626-4841. Sincerely, Jason Gabriel, Principal Civil Engineer cc: Christopher D. Peterson, Esq. 75J-7 Fair Market Value of the Subject Property Land and structures $512,000.00 (as per attached appraisal summary statement) i. Fixtures and equipment pertaining to realty + $ 56,025.00 (as per attached inventory — see Attachment 7) 2. Total just compensation $568,025.00 EXHIBIT A i. The City has not made a determination as to the ownership of the Fixtures and Equipment. Landlord and tenant will need to come to an agreement as to the ownership of these items, before compensation can be withdrawn from Escrow. 2. The total just compensation offered assumes that the property Is free of any environmental contaminates or other conditions which may impact fair market value. 75J-8 CLTA Preliminary Report Form (Rev, it/06) `t$, }.M a,, rt Firs%14mermin r1do Customer Reference: ATTACHMENT 1 Order Number: OSA-4443269 Page Number: 1 Updated 08/24/2015 First American Title Company 4 First American Way Santa Ana, CA 92707 Order Number: OSA-4443269 (bdaa) Title Officer: Bob Davies/ Ashley Aegerter Phone: (714)250-3094 Fax No,: (714)913.6388 E -Mail: octitle2ralfirstam,com Property: 2209 South Bristol Street Santa Ana, CA PRELIit7INARY REPORT In response to the alcove referenced application for a policy of title insurance, this company hereby reports that It Is prepared to Issue, or cause to be. Issued, as of the date hereof, a Policy or Policies of Tlde Insurance describing the land and the estate or Interest therein hereinafter set forth, insuring against loss which may be sustained by reason of any dell lien or encumbrance not shown or referred to as an Exception below or not excluded from coverage pursuant to the printed Schedules; Conditions and stipulations of said Policy forms. The printed Exceptions and Exclusions from tire coverage and Limitations on Covered Risks of said policy or policies are set forth in Exhibit A :attached. The pollcyto be Issued may contain an arbitration clsuise. When the Amount oflnsurante Islcass darn thatSet foath In Ow arhirmtoo claus4 all arbiteable m ellatsstaafi be arbitratod otthe option oreltherMe Lbmpanyor the insured as the m4ustve remAllyollhe patties. Limitations on Covered Risks applicable to the CLTA and ALTA Homeowner's Policies of hire Insurance which establish a Deductible Amount and a Maximum Dollar Limit of Liability for certain coverages are also set forth in Exhibit A. Copies of the policy forms should be read, They are available from the office which Issued this report. Please read tine exceptions shown or referred to below and the exceptions and exclusions set forth in Exhibit of this report carefully. The exceptionsand exclusions am meant to provide you with notice of matters which are not covered under the terms of the tine insurance policy and should be carefully considered, it is Important to note that this preliminary report . is not a written representation as to the condition of title and may not list all lions, defects, mid encumbrances affecting title to the land. This report (and any supplements or amendments horele) Is issued solely for the purpose of facilitating the issuance of a polity of tire Insurance and no liability is assumed hereby, If It Is desired that liability be assumed prior to the Issuance of policy, of title Insurance, a Binder or Commitment should be requested. RiFtAtnerlean Title Page 1 of 14 75J-9 Order Number; OSA-4443269 Page Number: 2 Dated as of August 24, 2015 at 7:30 A.M. The form of Policy of title insurance contemplated by this report is: To Be Determined A specific request should be made if another form or additional coverage is desired. Title to said estate or Interest at the date hereof is vested In: R & 5 PROPERTIES, LLC The estate or interest In the land hereinafter described or referred to covered by this Report is; FEE The Land referred to herein is described as follows: (See attached Legal Description) At the date hereof exceptions to coverage in addition to the printed Exceptions and Exclusions in said policy form would be as follows: 1, General and special taxes and assessments for the fiscal year 201.5-201.6, a lien not yet due or payable, 2, The lien of supplemental taxes, If any, assessed pursuant to Chapter 3.5 commencing with Section 75 of the California Revenue and Taxation Code. 3. An easement shown or dedicated on the Map as referred to in the legal description For: Public utilities and Incidental purposes. 4. Covenants, conditions, restrictions and easements in the document recorded April 13, 1948 as hook 1750�pgge 1St4 of Official Records, which provide that a violation thereof shall not defeat or render invalid the lien of any first mortgage or deed of trust made In good faith and for value, but deleting any covenant, condition, or restriction indicating a preference, limitation or discrimination based on race, color, religion, sex, sexual orientation, familial status, disability, handicap, national origin, genetic information, gender, gender identity, gender expression, source of income (as defined in California Government Code § 12955(p)) or ancestry, to the extent such covenants, conditions or restrictions violation 42 U.S.C. § 3604(c) or California Government Code § 12955. Lawful restrictions under state and federal law on the age of occupants in senlor housing or housing for older persons shall not be construed as restrictions based on familial status. Document(s) declaring modifications thereof recorded November 19, 1948 as Book 1762, Pam 484, and October 31, 1958 in Bonk 4467Pages 433 through 598, Inclusive, and in Boo l< 446IIt _Pages 1 through 121, inclusive, all of Official Records, F%1s't An7C1'ican Title Page 2 or 14 75J-10 Order Number: 05AA443244 Page Number: 3 S. An easement for public utilities and Incidental purposes, recorded May 12, 1948 as gook 1634E ap Ire 516 of Official Records. In Favor of; Southern California Edison Company Affects: As described therein An easement for public utilities and Incidental purposes, recorded June 2, 1948 as Book 1646, Pic e 155 of Official Records. In Favor of: Pacific Telephone and Telegraph Company Affects: As described therein 7, An easement for public street and incidental purposes, recorded August 12, 1980 as Instrument No. 13691 in Book .13G98&.Pacge_ 10o1 of official Records. In Favor of: The City of Santa Ana; a Municipal Corporation Affects; The Westerly 10.00 feet of said land 81 Abutter's rights of ingress and egress to or from Bristol Street, except that portion adjoining the southerly 17.00 feet of the Northerly 24.00 feet of said land, have been relinquished in the document recorded August 12, 1980 as Instrument No. 13691 in Book 13698Pae 1007 of Official Records, 9. A deed of trust to secure an original indebtedness of $372;000.00 recorded June 24, 2005 as Instrument No. 2005000491977 of Official Records, Dated: June 10, 2005 Trustor: R & S Properties,LLC Trustee: U.S. Bank Trust Company, N.A. Beneficiary: U.S. Bank N.A. 10. A deed of trust to secure an original indebtedness of $46,500,00 recorded June 24, 2005 as Instrument No. 2005000491978 of Official Records. Dated: Jame 23, 2005 "trustor; R&S Properties, LLC Trustee: Harumi Tomita, DDS Beneficiary; Harumi Tornita, DDS Fitst Amelican Title Page 3 or 14 75J-11 Order Number: OSA-4443264 Page Number: 4 Notes: a. If this deed of trust is to be eliminated in the policy or policies contemplated by this report/commitment, we will require all of the following prior to the recordation of any documents or the issuance of any policy of title Insurance: i. Original note and deed of trust. ii. Payoff demand statement signed by all present beneficiaries. M. Request for reconveyance signed by all present beneficiaries. b. If the payoff demand statement or the request for reconveyance is to be signed by a servicer, we will also require a full copy of the loan servicing agreement executed by all present beneficiaries. c. If any of the beneficial interest is presently held by trustees under a bust agreement, we will require a certification pursuant to Section 18100.5 of the California Probate Code in a form satisfactory to the Company 11. Rights of parties in possession. Prior to the issuance of any policy of title insurance, the Company will require: 12. With respect to R & S Properties, LLC, a limited liability company: a. A copy of its operating agreement and any amendments thereto; b. If it is a California limited liability company, that a certified copy of its articles of organization (LLC -1) and any certificate of correction (1-1-C-11), certificate of amendment (LLC -2), or restatement of articles of organization (LLC -10) be recorded in the public records; c. If it is a foreign limited liability company, that a certified copy of Its application for registration (LLC -5) be recorded in the public records; d. With respect to any deed, deed of trust, lease, subordination agreement or other document or Instrument executed by such limited liability company and presented for recordation by the Company or upon which the Company Is asked to rely, that such document or instrument be executed in accordance with one of the following, as appropriate: (i) If the limited liability company properly operates through officers appointed or elected pursuant to the terms of a written operating agreement, such document must be executed by at least two duly elected or appointed officers, as follows: the chairman of the board, the president or any vice president, and any secretary, assistant secretary, the chief financial officer or any assistant treasurer; (ii) If the limited liability company properly operates through a manager or managers identified in the articles of organization and/or duly elected pursuant to the terms of a written operating agreement, such document must be executed by at least two such managers or by one manager if the limited liability company properly operates with the existence of only one manager. e. Other requirements which the Company may impose following its review of the material required herein and other information which the Company may require First American Title Page 4 of 14 75J-12 Order Number: OSA-4443269 Page Number: 5 ---_----..,__.INFORMATIONAL NOTES-- ...__ Note: The policy to be Issued may contain an arbitration clause. When the Amount of Insurance is less than the certain dollar amount set forth in any applicable arbitration clause, all arbitrable matters shall be arbitrated at the option of either the Company or the Insured as the exclusive remedy of the parties. If you desire to review the terms of the policy, including any arbitration clause that may be included, contact the office that Issued this Commitment or Report to obtain a sample of the policy jacket for the policy that is to be issued in connection with your transaction. General and special taxes and assessments for the fiscal year, 2014-2015. First Installment; $3,206.42, PAID Penalty: $0.00 Second Installment: $3,206.42, PAID Penalty: $0.00 Tax Rate Area: 11-101 A. P. No.: 015.194-25 2.. According to the latest available equalized assessment roll In the office of the county tax assessor', there is located on the land a(n) Commercial Structure known as 2209 South Bristol Street, Santa Ana, California. 3. According to the public records, there has been no conveyance of the land within a period of twenty-four months prior to the date of this report, except as follows: None The map attached, if any, may or may not be a survey of the land depicted hereon. First American expressly disclaims any liability for loss or damage which may result from reliance on this map except to the extent coverage for such loss or damage Is expressly provided by the terms and provisions of the title Insurance policy, if any, to which this map is attached. First American Title Page 5 of 14 75J-13 Order Number: OSA-4443269 Page Number: 7 LEGAL DESCRIPTION Real property in the City of Santa Ana, County of Orange, State of California, described as follows: LOT 192 OF TRACT NO. 1192, IN THE CITY OF SANTA ANA, COUNTY OF ORANGE, STATE OF CALIFORNIA, AS PER MAP RECORDED IN BOOK 39, PAGES 16 AND 17, MISCELLANEOUS MAPS, IN THE OFFICE OF THE COUNTY RECORDER OF SAID COUNTY, APN: 015-194-25 Firs[American TiNe Page 7 of 14 75J-14 _Number; � _m Page Number: 8 e ~� !,; «w © \ : X21 e ~� !,; / : T]! 0 0 e ~� _m«r Page 8 of 14 75J-15 0 0 e 5\�e• \\\a\G 0 �&x®. 2»e ,eye \§\ \ ION 2 ®. \; \ _eILIla ^ � � z _m«r Page 8 of 14 75J-15 ATTACHMENT LEGAL DESCRIPTION THE LAND REFERRED TO HEREIN IS SITUATED IN THE STATE OF CALIFORNIA, COUNTY OF ORANGE, CITY OF SANTA ANA, AND IS DESCRIBED AS FOLLOWS: LOT 192 OF TRACT NO. 1192, IN THE CITY OF SANTA ANA, COUNTY OF ORANGE, STATE OF CALIFORNIA, AS PER MAP RECORDED IN BOOK 39, PAGES 16 AND 17, MISCELLANEOUS MAPS, IN THE OFFICE OF THE COUNTY RECORDER OF SAID COUNTY. 75J-16 ATTACHMENT STATEMENT OF VALUE AND SUMMARY OF THE BASIS FOR APPRAISAL Code of Civil Procedures § 1255.010(b) THE AMOUNT ESTABLISHED AS JUST COMPENSATION Government Code § 7267.2(a) OWNERSHIP R & S Properties, LLC The following is a Statement of Value and Summary of the Basis for Appraisal and the Amount that the client established as Just Compensation ("Summary") required by the California Eminent Domain Law. The appraisal on which this summary is based was made in connection with establishing the amount of compensation as required by Code of Civil Procedure section 1255.010(b). The appraisal on which this summary is based was made in accordance with accepted appraisal principles, consistent with California Valuation Law. A statement and summary described the basis for the appraisal from which the client established compensation. There follows the Statement of Value and Summary of the Basis for Appraisal and the Amount Established as Just Compensation ("Summary"): BASIS OF VALUATION The fair market value is based upon an appraisal prepared in accordance with accepted appraisal principles and methodologies. Code of Civil Procedure Section 1263.320 defines Fair Market Value as follows: (a) The fair market value of the property taken is the highest price on the date of valuation that would be agreed to by a seller, being willing to sell, but under no particular or urgent necessity for so doing, nor obliged to sell; and a buyer, being ready, willing and able to buy but under no particular necessity for so doing, each dealing with the other with full knowledge of all the uses and purposes for which the property is reasonably adaptable and available. (b) The fair market value of property taken for which there is no relevant comparable market is its value on the date of valuation as determined by any method of valuation that is just and equitable. Section 1263.330 provides that the fair market value shall not include an increase or decrease in the value attributable to the project for which the property is to be acquired. 75J-17 The property is being appraised for the possible full acquisition by the City of Santa Ana to assist in negotiations with the property owner for the possible full acquisition of the subject property as a part of the Bristol Street Widening Improvement Project, DESCRIPTION OF THE SUBJECT PROPERTY Ownership: R & S Properties, LLC Location: 2209 South Bristol Street, Santa Ana, California 92704 Assessor's Parcel No.: 015-194-25 Date of Value: November 29, 2016 Property Rights Appraised: Fee simple Site Area: Approximately 6,534 square feet, or 0,15 acre, according to public records. Zoning: According to the City, the larger parcel is zoned O (Park), within the Bristol Street Corridor Specific Plan designated by the City of Santa Ana. The purpose of the O District is to provide for permanent open spaces in the city. Present Use: Highest and Best Use (As Vacant): Highest and Best Use (As Improved): Commercial Retail development Continue the existing use Improvements: Public records indicates a building area of 854 square feet. Take -oft measurements made at the time of inspection indicate a building area of ±1,164 square feet which is utilized in the valuation. It was originally constructed in 1980. Description of Acquisition: A full acquisition is proposed 75J-18 SALES COMPARISON APPROACH The estimated fair market value of the subject property Is based on improved sales data for other properties with essentially the same utility and amenities. The subject property is located on a primary arterial street and the property benefits from good access and visibility. To analyze the value of the subject property, a search was conducted of the market area for similar improved office building sales. Very few transactions were found in Santa Ana. The search was expanded to surrounding areas and included small office buildings that sold throughout Orange County since January 2015, built before 1990 and between 1,000 and 10,000 square feet in size. Of the comparables discovered, the six most similar properties were chosen for comparison. The comparables reflect selling prices ranging from $385,000 to $1,175,000, which is approximately $302 to $472 per square foot of building area, or approximately $52 to $161 per square foot of land area. Office buildings of this size are primarily purchased for owner -occupancy whereby the fee simple interest is conveyed. The primary approach used in this market by owner -users is the sales comparison approach. As such, the sales comparison approach is developed to provide an indication of the fee simple market value. The comparable sales are analyzed using the price per square method, which is the typical basis used by buyers in this market. This unit of measure provides a reliable basis of comparison for the assignment. As a check to the reasonableness of the conclusion price per square foot of land area is also reviewed. Adjustments are considered for transactional differences as well as for physical differences between the subject property and comparables. Included on the following page is a Comparable Improved Sales Summary. 75J-19 75J-20 CAM PARABLE IMPROVED SALES SUM MARY Location COE Date Bldg Size SF Year Built Bales Rice APN Doc No. Land Area Sc Site Co, Price PSF/Bldg Comments Price PSF/Lend SLID -ECT PROPERTY 2209$&18.1 Sms, WApp 1,164 1986 WApp Thaabject grope-ty isutliizei asadankd menta Ana,CA92704 Wfpp 6,534 1@% WApp office. tocalei mid -black an Bristol S., with good vistally. AAT= approx. 35,000 cpd 016-194-25 Comparable No. 1 3105 Mein Sreet 7/14/2016 2,120 1917 $640,000 Sngletanwt commercial building weed me Santa Alla, CA92701 321338 8,025 35% $301.89 bakery for the lust 80 year& The broke reports 390-28MB $106.22 nN.v roof, Netting, exterior pant and or Guenter: Barbara Lynne Orr and (merge fbLo t Mderdr, A al, conditioning unit, Qanlee: 3641 LaSagaPcal F4Rn.RrtnasI-LC Comparable No. 2 151714th Cres 7/23/2015 1,200 1924 $385,000 tae of.b.ilding icrread near the Fedxa Santa Ana, CA92701 382743 7,405 16% $320.83 Court Arllding. Average acceg'Nnhillty on 398-392-19 $51.99 secondary trot, The broker reports that the Grantor: Ptztf Karhe' propeiy is in weraae mime condition, end In need of updating, Grantee: Nrmer4 LLC Comparable No, 3 1502 N Man Bros. A= 1,767 1919 $586,123 Oder BRmnvatal for office use, Gv d Santa Ana, CA 92701WA 7,733 23% $331.77 accaYvldb111ty on an ale' IN street. pier see In 006-153-12 $75.80 May 2013 for $449,000, or $254/87, Qallor: Wk Family Trust cartes: WA Comparable No. 4 924 E Onspun. Avenue 9/2912016 2,224 '1921 $1,050,000 Converted S -R usel for an of Oce. Gond Ganga CAS2866 47422 6,534 34% $412,12 a:c Nhlllty on an creedal srotl. 390-351-02 $150.70 Grantor: toast Sera League, Inc, C?&nice: ❑23 LLC Comparable No. 5 7891 Westminster Bauierxd 9/1312016 2,586 1056 $1,175,000 87R converted for office use Average Wa:tminser, CA 92683 435061 13,876 19% $454.37 of Idbility on ai arteria tree, 096325-03 and -24 $84.68 Qantor. Fichad tong The Nguyen Grantee: LDHT Family F1 nineties 75J-20 Conclusion After adjustments for market conditions, the comparables establish a fair market value range for the subject property between $309 and $479 per square foot as shown in the following table. Comparable Nos. 1, 2 and 3 are rated inferior, while Comparable Nos. 4 and 5 are rated superior. Based on the subject property's size, location and condition, a value above $348 per square foot, but below $461 per square foot is indicated for the subject property. Indicated Values Comparable Overall Indicated $/SF No. Comparability 4 Superior $479 5 Superior $461 Subject $440 2 Inferior $348 3 Inferior $315 1 Inferior A fair market value of $440 per square foot is concluded. Based on the preceding investigation and analysis, the fair market value of the subject property, as of November 29, 2016, is calculated as follows: INDICATED VALUE - SALES COMPARISON APPROACH 1,164 SF X$440 PSF $512,160 ROUNDED 75J-21 $512,000 INCOME APPROACH The subject property is an owner -occupied, single-family residence which has been converted and utilized as a medical office building, As such, the fee simple value is analyzed using market rent and expenses. Market Rent Analysis A survey of Santa Ana and the surrounding cities for recently executed leases and asking rents for office space ranging from 656 to 3,279 square feet in size is used in the analysis. The important factors considered during selection of the comparables include location, building area, visibility and access. The search focused on properties with arterial street visibility, but data for such properties was found to be somewhat limited; however, sufficient data was available to estimate a market rental rate for the subject property. The survey properties indicate that rents are written on a triple -net, modified gross, and full service gross basis. For valuation purposes, a triple -net basis will be utilized. For triple -net leases, the tenants pay operating expenses such as property taxes, insurance, tenant utilities and janitorial, common area maintenance and utilities, building repairs and maintenance, security, parking and sometimes management (or a portion of management). These expenses are normally recouped by the landlord in the form of an expense reimbursement charge. The landlord is still responsible for non -reimbursed management (collecting the check and watching over the property) miscellaneous expenses such as those incurred between tenancy, accounting, legal, miscellaneous and replacement of short-lived items such as the roof, air-conditioning units and exterior walls, if applicable. Based on the review of the rental data and after consideration for differing property characteristics, it is concluded that a rental rate of $1.80 per square foot per month, triple -net, for the subject property is reasonable for the analysis and is used in the direct capitalization analysis. The estimated market income for the subject property is calculated in the following table: CONCLUDED MARKET RENT Building Market RentlSF Market Annual Market Size Mo. Rent/Mo. Rent 75J-22 1,164 SF $1.80 $2,095 $25,142 Vacancv and Collection Loss Small office buildings are most frequently purchased for owner -occupancy and are analyzed using the sales comparison approach, with values calculated assuming no vacancy or collection loss. However, from the perspective of an investor, a stabilized vacancy and collection loss within the historical range is usually applied, assuming a five- to 10 -year holding period. An estimated stabilized vacancy and collection loss of 3% is considered appropriate for the direct capitalization analysis. Expense Analysis The subject property is an owner -user office building. Typically, leases for similar buildings in this market are written on a triple -net lease basis, where the tenant is responsible for operating expenses for the property including: taxes, insurance, utilities, common area maintenance, building repairs and maintenance. The owner is responsible for management, miscellaneous expenses, and administrative costs. The capital value analysis has been analyzed on a typical triple -net basis. Overall Capitalization Rate A review of sales and listings of office properties found that reported OARS reflect rates from 4.00% to 5.00%. These sales are considered the best evidence of an appropriate capitalization rate for the subject property. 75J-23 DIRECT CAPITALIZATION ANALYSIS Office Building 2209 S. Bristol Street Santa Ana, California INCOME: Rental Income Annual Market Rental Income Monthly Imetal Income $1.80 FG: x 12 Months $25,142 Total Leaseable Area 1,164 FF Total Potential Gross income $25,142 Vacancy 3% $23,784 754 Effective Gross Income Indicated Value at Market fent $24,388 REIMBURSABLE EXPENSES: $500,000 $/SF Management 2.0% ($0.42) ($468) lem'Ves 1$0 101 IQ116} Total Reimbursable Expenses ($0.52) ($604) 604 Net Operating Income $23,784 Capitalization Rate 4.75° Indicated Value at Market fent $500,715 ROUNDED $500,000 *Difference may be due to rounding. Income Approach Conclusion The direct capitalization analysis and resulting indication of market value via the income approach is shown on the following page. The indicated fair market value, as of November 29, 2016, is as follows: INDICATED VALUE - INCOME APPROACH $500,000 75J-24 CONCLUSION OF VALUE The approaches most often relied on by buyers of this type of property have been developed. Thus, the sales comparison approach Is developed as the primary value indicator. The cost and income approaches are rarely considered by buyers in this market and are less reliable than the sales comparison approach as the typical buyer of the subject property would be an owner -occupant.. There are limited investor sales with reported overall capitalization rate data in this building market segment and data for signed leases is of limited quantity and quality, The income approach has been developed, but is given less weight in the final conclusion of value. The cost approach is rarely used by buyers in this market and does not tend to produce reliable valuation results, the cost approach has not been developed. Considering the data and analyses presented, the opinion has been formed that as of November 29, 2016, the fair market value of the subject property is: INDICATED VALUE Sales Comparison Approach $512,000 Income Approach $500,000 Reconciled Value (Rounded) $512,000 The above is a summary of my appraisal prepared at the request of, and to be used by, the client to comply with Code of Civil Procedure Section 1255.010(b). My appraisal is the basis for this summary and was made in accordance with accepted appraisal principles, consistent with California Valuation Law. Stephanie L, Kavanaugh, Certified General Real Estate Appraiser, Certificate No. AG030565, provided assistance in this assignment. BY: Of, w Elizabeth M. K1i At, AI-GRS Certified General Real Estate Appraiser Certificate No, AGO05391 Expiration Date; April 13, 2018 Dated: January 10, 2097 75J-25 CERTIFICATION We certify that, to the best of our knowledge and belief: 1. The statenicats of fact contained in this report are true and correct. 2. The reported analyses, opinions, and conclusions are limited only by the reported. assumptions and limiting conditions and are our personal, impartial, and unbiased. prormsioua l analyses, opinions, and conclusions. 3. We have previously appraised the subject property in our file NO. 15-5292, dated December 5, 2015, A. We have performed no services, as appraisers or in any other capacity, regarding (lie property that is the subject of this report within the past three-year period immediately preceding acceptance of this assignment. 5. We have no bias with respect to the property that is the subject of this report or to the parties involved in this assignment. 6. Our engagement in this assignment was not contingent upon the developing or reporting predetermined results, 7. Our compensation is not contingent on the development or reporting of a predetermined value or direction in value that favors the cause of the client, the amount of the value opinion, the attainment of a stipulated result, or the occurrence of a subsequent event directly related to the intended use of this appraisal. & Out analyses, opinions, and conclusions were developed, and this report has been prepared, in conformity with the Uniform Standards of Professional Appraisal Practice, 9. Stephanie Kavanaugh has made a personal inspection of the property that is the subject of this report. Elizabeth M, Kiley has not made an inspection of the subject property, but has fiilly participated in the analyses, opinions and conclusions concerning real estate contained in this report and fully concurs with the conclusions expressed herein, 10. No one provided significant real property appraisal assistance to the persons signing this certification, 11, The reported analyses, opinions and conclusions were developed, and this report has been prepared in conformity with the Code of Professional Ethics and. Standards of Professional Appraisal Practice of the Appraisal institute. 12. The use of this report is subject to the requirements of the Appraisal TnnAitute relating to review by its duly authorized representatives, 13. As of the date of this report, Elizabeth M. Filey has completed the continuing education program for Designated Members of the Appraisal Institute, Elizabeth M. Kiley, MAI, Al-GRS Stephanie L. Kavanaugh Certified General Real Estate Appraiser Certified General Real Estate Certificate No. AGO05391 Certificate No. AG030565 Expiration Date: April 13, 2018 Expiration Date: April 12, 2017 75J-26 ATTACHMENT SUMMARY EXPLANATION STATEMENT You are entitled to receive full payment prior to vacating the zeal property being purchased unless you have heretofore waived such entitlement. You are not required. to pay recording fees, transfer taxes, or the pro rata portion of real property taxes which are allocable to any period subsequent to the passage of title or possession. 1. The holders of liens, deeds of trust or other security interests in your property and/or any leases or tenants of youur property may be entitled to all or a portion of the consideration to be paid by the City of Santa Ana ("City") for your property in accordance with the particular contracts) existing between you and the lien holder or lessee/tenant. 2. All buildings, structures, and other improvements affixed to the land described in the reference documents covering this transaction and. owned by the grantor herein or, if applicable, owned by you as a tenant are being conveyed unless other disposition of these improvements have been made. The interest acquired is fee title. 3. The amount determined to be just compensation was determined after consideration of an appraisal of the fair market value of the Parcel. The basis for the amount determined to be just compensation. is siunmarized on the attached Appraisal Summary Statement (Statement of'Just Compensation) and the amount of the Purchase Price: a. Is the full amount believed by the City to be just compensation for the property taken; b. Is not less than the approved appraisal of the fair market value of the property as improved; c. Disregards any decrease or increase in the fair market value of the public improvement for which the property is to be acquired for such public improvement, other than that due to physical deterioration within the reasonable control of the owner or occupant; and Reflects the definition of"fair market value" as defined in Eminent Domain Law (California Code of Civil Procedure Section 1263.320) which is "the highest price on the date of valuation that would be agreed. to by a seller being willing to sell but tinder no particular or urgent necessity for doing so, nor obliged to sell, and a buyer, being ready, willing and able to buy butu nder no particular necessity for so doing, each dealing with the other will full knowledge of all the uses and purposes for which the property is reasonably adaptable and available." e. Does not reflect any consideration of or allowance for any relocation assistance and payments or other benefits which the owner is entitled to receive under an agreement with the public entity. 4. If you ultimately elect to xeject the offer made by the City of Santa Ana for your property, you are entitled to have the amount of compensation determined by a court of law in accordance with the laws of the State of California. 75J-27 ATTACHMENT 5 CITY OF SANTA ANA Public Works Agency 20 Civic Center Plaza M-36 Santa Ana, CA 92702 75J-28 Door Property Owner: Our State and Federal Constitutions recognize the need for public agencies to purchase private property for public use. The Unitorm Relocation Assistance and Real Property Acquisitions Policies Act of 1970 (Uniforr Act), or similar State Legislation and em nent domain law of the State of California authorize purchase of private property for public use and ensure that owners of real estate (real property) to be acquired are treated fairly and consistently. This Handbook provides a brief smumany of the City's acquisition procedures and various laws it isnot intended to give a complete statement of all state or federal laws and regulations pertaining to the purchase of your property for a public use, technical legal definitions or any form of legal advice. Recipients of offer letters from the City should be aware that such laws and procedures are subject to change by future legislation and/or court decisions. In the event the City decides to proceed with the proposed acquisition, City's acquisition consultant will contact you. 75J-29 AME OF CONTE, NTS PAGE WHY IS MY PROPERTY REQUIRED? 1 WHAT RIGHT DOES THE CITY HAVE TO ACQUIRE MY PROPERTY? 7 WHO MAKES THE DECISION TO BUY MY PROPERTY? I HOW WILL THE CITY DETERMINE HOW MUCK TO OFFER ME FOR MY PROPERTY? I WHAT IS FARC MARKET VALUE? 1 HOW D OES AN APPRAISER DETERMINE THE FAIR MARKET VALUE OF MY PROPERTY? 2 WILL I HAVE A CHANCE TO TALK TO TIM APPRAISER? 2 ONCE THE CITY DETERMINES THAT MY PROPERTY IS NECESSARY FOR A PUBLIC 7 PROJECT, HOW SOON WILL THE CITY GIVE ME A WRITTEN PURCHASE OFFER? 2 WHAT IS IN THE CITY'S STATEMENT OF THE BASIS FOR ITS DETERMINATION 2 OF NST COMPENSATION? CAN I GET AN APPRAISAL? 3 MUST I ACCEPT TIRE CITY'S INITIAL OFFER? 3 MAY IHAVE SOMEONE REPRESENT ME DURING NEGOTIATIONS? 3 IF I AGREE TO ACCEPT THE CITY'S OFFER, HOW SOON WILL I BE PAID? 4 WHAT HAPPENS IF I DO NOT AGREE TO THE FINAL PURCHASE OFFER? 4 WHAT HAPPENS IF THE CITY CONDEMNS MY PROPERTY? 4 WHAT IS AN ORDER OF POSSESSION? q WILL I HAVE TO PAY ANY SETTLEMENT COSTS? $ MAY' I KEEP ANY OF TIIE BUILDINGS OR OTHER IMPROVEMENTS ON MY PROPERTY? S CAN THE CITY TAKE ONLY A PART OF MY PROPERTY? 6 WILL I HAVE TO PAY RENT TO TIM CITY AFTER MY PROPERTY IS ACQUIRED? 6 HOW SOONMUST I MOVE? 6 AMIENTITLED TO RECOVER LOSS OF BUSINESS GOODWILL? 6 I AM A VETERAN, IIO W ABOUT MY GI LOAN? 7 My PROPERTY IS WORTH MORE NOW THAN WHEN I BOUGHT IT. MUST I 7 PAY CAPITAL GAINS TAX ON THE INCREASE? WHAT IF IHAVE OTHER QUESTIONS ABOUT THE PROCESS? 7 75J-30 WHY IS MY P OPERTY RE, QUMED? The City of a"anta .Ana, Public Works Agency (the City), has determined that your property may be required for the improvements of Bristol Street. WfIAT RIGHT DOES THE CM HAVE' TO ACQUIRE MY MOPERT Y! Every public agency has certain powers that are necessary for it to operate effectively, For example, States have the power to levy taxes and the power to maintain order. Another power is the power to acquire private property for public purposes. This is known as the power of the eminent domain. The rights of each of us are protected by the Fifth and Fourteenth Amendments of the U.S. Constitution, the State Constitution and eminent domain laws which guarantee that if a public agency takes private property it must pay "just compensation" to the owner. Further, under the California Government Code and Title 25 of the California Code of Regulations, the owner has additional protections, some of which are explained in Ibis brochure. WHO 1 MKE'' S THE DECISION TO BUY MY FROFERTY? The decision to acquire specific property for a public project usually involves many persons and many decisions. The final decision to proceed with a project is made by the Santa Ana City Council after a thorough review that includes public hearings to obtain the views of interested citizens. HOW WALL THE CITY DETERM NE HOW MUM TO OFFER ME FOR MY PROPERTY? Before making you an offer, the City will obtain an appraisal of your property. A qualified, licensed, professional appraiser who is familiar with local property values will do the appraisal. The appraiser will inspect your property and state his or her professional opinion of its current fair market value in an appraisal report. The City is required to offer you "Just compensation" for your property. This amount cannot be less than the fair market value of your property, as determined by the City on the basis of its approved appraisal. WHAT IS FAM A AR ET VALUE? The fair market value of real property being taken for a public project Is the highest prlce on the date of valuation that would be agreed to by a seller, being willing to sell but under no particular or urgent necessity for so doing, nor obliged to sell, and a buyer, being ready, willing, and able to buy but under no particular necessity for so doing, each dealing with the other with full knowledge of all the uses and purposes for which the property is reasonably adaptable and available. 75J-31 ty t HOW DOES AN APPRAISER D1TERMINEi T= FAIR MAWMT VALUE, OF lid PROPERTY? Each parcel of real property is different and therefore no single formula can be devised to appraise all properties. Among the factors an appraiser typically considers in estimating the value of real property are: How it compares with similar properdes in the aroa that have, been sold recently. How much it would cost to reproduce the buildings and other structures, less any depreciation. How much rental income it could produce after expenses and how investors typically value that income. WILL I HAVE A CHANCE TO TALK TO THE APPIIAISER? YES, You must be contacted and given the opportunity to accompany the appraiser on the inspection of your property. You may then inform the appraiser of any special features that you belleve may add to the value of your property, It is in your best interest to provide the appraiser with all the useful information you can in order to insure that: nothing of allowable value will be overlooked. If you prefer, you may designate a representative in writing for this purpose. ONCE THE CITY DETERMINES THAT MY PROPERTY IS NECESSARY FOR A PUBLIC PROJECT, HOW SOON WILL THE CITY GIVE ME A WRITTEN PURCHASE OFFER? The timing of a purchase offer depends on the following factors: • The amount of work required to appraise your property, • The availability of £undurg; and • Possible project delays caused by factors outside the control of the City. Typically, when there are no funding issues or other project delay factors, you can expect a written purchase offer within 60 days of completion of the appraisal. The appraisal for business or industrial property can take several months to complete due to the much greater complexity involved. The City will give you a written offer to acquire your property for the full amount determined to be just compensation, and it will do so promptly. Along with the offer you will receive a written statement explaining the basis for the determination of just compensation. The City will not initiate negotiations until the purchase offer is sent out and your receipt of the offer is acknowledged. WHAT IS IN TIIC CITY'S STATEMENT OF THE BASIS FOR ITS DETERMINATION OF JUST COMPENSATION? The City's "statement of the basis for its determination of just compensation" will be provided to you with the written purchase offer. Among other things, this statement win include: b The recognized deEnition of the term "fair market value" or the equivalent term. 75J-32 m The date of valuation, highest and best use, and applicable zoning of property. • An accurate description of the property to be acquired. • A list of the improvements covered by the offer. • The principal transactions, reproduction or replacement cost analysis, or capitalization analysis, supporting the determination of value, • The amount of the oftbr. • Where appropriate, the just compensation for the real property acquired and for damages to remaining real property shall be sepat'ately stared and shall include the calculations and nartative explanation supporting the compensation, including any offsetting benefits. • An indication that the off0r does not reflect any relocation payments or other relocation assistance that you may receive under other regulations. CAN I GET MY OWN APPRATSALY YES. Pursuant to the California Code of Civil ProcedureSection 1263,025 should you elect to obtain an independent appraisal, the City will pay for the actual reasonable costs up to $5,000 subj cot to the following conditions; • You may order your own Independent appraisal. Should you enter into a contract with the selected appraiser, the City will not be a party to the contract. • The selected appraiser you select .must be licensed with the California State Office of Real Estate Appraisers (ORE.A ). • At the time the City makes its offer to you, it will offer to pay you the reasonable cost, not to exceed $5,000 of the cost of your independent appraisal. • Appraisal cost reimbursement requests must be made in writing and submitted to the City of Soma Ana, Public Works.Agency, 20 Ovie Center PlazaM--36, San taAYxa, CA 92702, within ninety days of the earliest of the following dates: (1) the data the selected appraiser requests payment from you for the appraisal, or, (2) the date upon which you, or someone on your behalf, remitted full payment to the selected appraiser for the appraisal. Copies of the appraisal contract (if a contract was made), appraisal report, and invoice for completed work by the appraiser must be provided to the City concumentv✓ith submission of the appraisal cost reimbursement request. All appraisal costs must be reasonable and justifiable. MUST I ACCEPT THE CITY'S INITIAL OFFER? NO. You are entitled to present your evidence as to the amount you believe is the value of your property and to make suggestions for changing the terms and conditions of the offer. The City will make reasonable efforts to consider and respond to your evidence and suggestions (including an appraisal). When fully justified by the available evidence of value, the City may make a revised offer. MAY I HAVE SOMEONE REPRESENT ME DURING NEGOTIATIONS? YES. You may have an attorney or anyone else represent you during your negotiations with the City. If you choose to have representation during the negotiations, please so inform the City in writing. You will be responsible to pay the costs of any such representation. 3 75J-33 IFI ACRES TO ACCEPT TM CITY'S OFFER, HOW SOON WILL I BE PAID? If you and the City reach an agreement for the purchase of your property by the City and your ownership (title) is clear, payment to you will be made at a mutually acceptable time, Generally, you can expect to be paid in about ninety (90) days after the City signs the Purchase Agreement. If the title evidence obtained by the City indicates that further action is necessary to show that your ownership is clear, you may be able to hasten the payment by helping the City to obtain the nocessary proof, (Title evidence is a legal record of ownership of the property. It identifies the owners of record and lists the restrictive deed covenants and recoxded mortgages, liens and other instruments affecting your ownership of the property_) WHAT HAPPENS IF I DO NOT ACRE TO TIME FINAL PUnCIIASE O { (ER By THE CITY? If you and the City are unable to roach an agreement through negotiations, the City will then either institute formal eminent domain (condemnation) proceedings to acquire the property or abandon its intention to acquire the property. In the latter case, the City will give you notice of its decision as provided by law. WHAT RWYEI NS IF THE CITY CONDEMNS MY PROPERTY? The power of eminent domain may only be exercised if 1) the public interest and necessity require the project, 2) the project is planned or located in the manner that will be most compatible with the greatest public good and the least private injury; and 3) the property sought to be acquired is necessary for the project. Eminent domain proceedings are often referred to as condemnation actions,. The City may only file a condemnation action after the adoption of a Resolution of Necessity by its Board of Directors. Such resolution must be adopted at a public hearing, of which the owner(s) of the property will receive written notice at least 15 days in advance of the hearing. After the hearing, assuming need and necessity has been substantiated and determined, the City can file a condemnation suit. Dining the condemnation action, you will be provided an opportunity to introduce your evidence as to the value ofyotu property. The City will have the same right. After hearing the evidence of all parties, the court or a. jury will determine the amount of just compensation to which you are entitled. In the State of California, a property owner and the City have a constitutional right to have a jury determine the value of the property in question. If the owner and the City decide to waive their right to a jury trial, a judge can determine just compensation. To help you in presenting your case in a condemnation proceeding, you may wish to consider employing an attorney and an appraiser. However, the costs of those professional services and other costs that you incur in presenting your case to the court are your responsibility unless the court orders that you are to be reimbursed for your litigation expenses, VVRH T IS AN ORDER OF POSSESSION? An order of possession is a process within a condemnation action that allows the City to have the possession of your property prior to a negotiated settlement or an award of just compensation in 75J-34 court, This procedure is used typically where the possession of your property is necessary to accomplish timely construction of the project for which your property is being acquired. To obtain an order of possession, the City must deposit with tho court an amount not less than its appraisal of the fair market value of the property. Ordinarily, the owner or lessees are then permitted to withdraw their share of this amount LESS any amounts necessary to pay off any mortgage or other liens on the property and sums necessary to resolve any special ownership problems. A withdrawal of the deposit by the property owner results in a waiver by the owner of the right to challenge the City's authority to take the property, but does not waive the owners right to seek additional compensation. Early withdrawal of your share of the money will not affect your right to seek additional compensation for your property. Should the negotiated settlement or court award exceed the amount deposited by the City, you will be paid the d4orenee plus any interest and costs as provided by law. WILL I HAVE TO PAYANY SETTLEMENT COSTS? If you and the City enter into all agreement for the City's purchase of your property, you will not be responsible for the reasonable and necessary costs of: m Escrow fees and fees for other services typical in a real estate transaction, recording fees, transfer taxes and any similar expenses that are incidental to transfer ownership to the City. ® Penalty costs and other charges necessary to permit prepayment of an earlier recorded mortgage on the property that was entered into in good faith. Read property taxes covering the period af}erthe City acquires your property, Escrow or the City will identify these items in a Preliminary Closing Statement or equivalent to be given to you at the time of settlement. Ordinarily, if you have paid say of these expenses yourself, you will be repaid at that time. If you later discover other costs for which you should be repaid, you should request repayment from the City within six months after the acquisition. City will assist you in processing your claim for these costs. If there are loans or other liens and encurabrances against the property, you will be responsible for paying them from the purchase price being paid to you by the City. MAY I KEEP ANY OF THE PIlMMNGS OR OTHER )W OVEMENTS ON MY PROPERTY? Sometimes, improvements may exist on a property, which are not required by the City. If you wish to keep any of the improvements, please let your Acquisition Agent know. if you do arrange to keep any improvement(s), the City will deduct its salvage value from the purchase price you would otherwise receive. (The salvage value of an item is its probable selling price if offered for sale on the condition that the buyer will remove it at his or her own expense.) If you arrange to keep any improvement pertaining to the property, you will not be entitled to receive a relocation payment for the cost of moving it to anew location. . 5 75J-35 CAN TIS CITY TAKE ONLY A PART O& MY PIR OPERTY? YES. But, if the purchase of only a part of your properly reduces the value of the remaining part(s), you must be paid for the loss in value (offset by any special benefits accruing to the remainder resulting from the new public improvements). Also, under those circumstances, if any remaining part would have little or no utility or value to you, the City will offer to buy that remaining part if you so desire. WILL I HAVE TO PAY RENT TO TIM, CITY AFTER MY PROPxRTY IS ACQUIRED? If you (or your tenant) wish to remain in the property after acquisition for a short terra or for a period subject to termination by the City on short notice, you will be required to sign a rental agreement or similar document. The rent will not exceed the lesser of the fair rental value of the property to a short-term occupier or the prorated portion of the fair rental value for a typical rental period. However, the amount of rent to be paid by your or your tenant shall be within your financial means or your tenant's financial means, as the case may be. HOW SOONMUST IMOVE? If you reach a voluntary agreement to sell your property, you cannot be required to move before YOU receive the agreed purchase price. in the case of a condemnation, you cannot be required to move before the estimated fair market value of the property has been deposited with the court so that you can withdraw your share. Every reasonable effort will be made to give you ample time to relocate after the acquisition of your property, In most cases, a mutually satisfactory arrangement can be worked out. You cannot be required to move without at least 90 days advance written notice of the date by which your move is required. In addition, if you are being displaced from your residence, a decent, safe and sanitary replacement ,property must be available before you can be required to move. AM I ENTITLED TO RE' COVER LOSS OF BUSINESS GOODWILL? The offer of compensation made by the City does not include any consideration for loss of business goodwill, which may be claimed by an owner of a business if one is being conducted on the property or on the remainder if the property being acquired is part of a larger parcel. Code of Civil procedure Section §1263.510 Loss of Goodwill Compensation Basis: (a).The owner of a business conducted on the property taken, or on the remainder if such property is part of a larger parcel, shall be compensate d for the loss of goodwill if the owner proves all of the following: (1) The loss is caused by the taking of the property or the injury to the remainder. (2) The loss cannot reasonably be prevented by relocation of the business or by takhrg steps slid adopting procedures that a reasonably prudent person would take and adopt in preserving the goodwill. (3) Compensation for the loss will not be included in payments under Section 7262 of the Government Code. 75J-36 (4) Compensation for the loss will not be duplicated in the compensation otherwise awarded to the owner. (6) Within 'the meaning of this article, "goodwill" consists of the benefits that accrue to a business as a result of its location, xoputation for dependability, sldll or quality, and any other circrunstances resulting iii probable retention of old or acquisition of new patronage I AM A VETERAN, :SOW A-UOIIT MY GI LOAN? After your GI home mortgage loan has been repaid, you will be permitted to obtain another GI loan to purchase another property. Check on such arrangements with your nearest VA office. MY PROPERTY IS WORM MORE NOW TRA.N WREN I IJOUGMr IT. MUST I PA'Y' CAPITAL GAINS TAX ON THE IDICREASE? In most cases when the City acquires real property by condemnation or the threat of condemnation, the property owner may defer the payment of Federal capital gains taxes on profit from the sale under certain circumstances. Internal Revenue Sex -vire (IRS) Publication 344, "Sales and Other Dispositions of Assets" Is available from the IFS. It explains how the Federal income tax would apply to a gain or loss resulting from the condemnation of real property or its sale under the threat of condemnation for public purposes. To fully understand the income fax consequences relating to the condemnation of your property, you should consult with your personal tax advisor. 75J-37 ATTACHMENT 6 STATEMENT OF OWNERSHIP PERSONAL PROPERTY, TENANT IMPROVEMENTS, FIXTURES AND EQUIPMENT PARCEL NO.: PROJECT: CCU: TENANT'S NAME: ADDRESS: CITY/STATE/ZIP CODE: The undersigned tenant agrees that the items listed on the attached inventory are owned by him or her. Date: Tenant PROPERTY OWNER'S NAME: ADDRESS: CITY/STATE/ZIP CODE: The undersigned tenant agrees that the items listed on the attached inventory are owned by him or her. Date: Property Owner _ Please have each signature on this document notarized, 75J-38 ATTACHMENT 7 MODERN AGE DENTISTRY DBA AMERICAN SMILE FAMILY DENTISTRY IMPROVEMENTS PERTAINING TO THE REALTY EFFECTIVE DATE OF VALUE- OCTOBER 15,20 15 Fair Market Item No. Qty. Description Value in Place I 1 Sign, channel letters, 8"-12" high, metal cabinet, interior $4,700 illumination, plastic fascia, metal trim cap, "American Smile", I O' x 4' metal cabinet backing, with illuminated accents I logos / box signs, vinyl letters, "Family Dentistry / (1 714-622-2333), electrical, wall-raounted 2 2 Signs, 78" x 3', metal cabinet, interior illumination, 6,850 plastic fascia, vinyl letters, "American Smile", pedestal mounted, 24" high, painted sheet metal enclosure 3 1 Dcor/window blinds, 30" x 6, 2" wood slots, horizontal 65 4 1 Television wall mount, metal 105 5 1 Service/reception counter, 65" x 16", laminate ISO 6 4 Surveillance cameras, manufacturer and model no. not 1,500 available, dome housing type, including'wall mounts and video cabling to DVR 7 1 Alarm system, Honeywell, consisting of 560 1 Control panel 1 Code, pad 2 Motion sensors 2 Door contacts 2 Glass break detectors 8 1 Built in reception desk, 14 linear feet x 24" deep, 1,900 laminate, double pedestal, 4 -drawer, including side service counter, 36" wide x 15" deep, laminate 9 1 Wall shelf, 7' x 3'x 12", laminate, 3 -tier, 15 cubbyholes 300 10 2 Medical wall shelves, 31" x 91 " x 14", laminate, 5 -tier, 1,500 2 lower doors 11 I Wall mirror, 60" x40", beveled edge 175 12 4 Ceilingspeakers, l2"diameter, including audio cabling 625 to stereo, through -roof 75J-39 MODERN AGE DENTISTRY DBA AMERICAN SMILE FAMILY DENTISTRY IMPROVEMENTS PERTAINING TO THE REALTY EFFECTIVE DATE OF VALUE - OCTOBER 15, 2015 Pair Market ]tern Value in No. Qty. Description Place 13 104 Square feet ofverticalvindow blinds, 3.5" slat, plastic 875 14 2 Thru-wall X -Ray cabinets, 4'x 4'x 16", laminate, dual 2,900 sided, bifolding doors 15 4 Operatory dental cabinets, 4' x 19", laminate on wood, 3,750 4" high backsplash, 2 -door, 6 -drawer 16 4 Dental sink cabinets, 4'x 19", laminate on wood, 4" high 6,300 backsplash, 1 drop-in sink, 15" x 5" x 15", stainless steel, single mixing faucet, plumbing, I trash chute, 6" diameter, 4 -drawer, 2 -door 17 1 Wall cabinet, 36" x 30", laminate, 2 -door 305 18 1 Accordion/folding door, 36" x 80", vinyl i 190 19 10 Linear feet of built-in laboratory base cabinctry, 3,850 L-shaped, 24" deep, 4" high backsplash, 10 -drawer, 4 -door, I drop-in dual sink, 33" x 5" x 22", stainless steel, single mixing faucet, emergency eye wash, 20 10 Linear feet oflaboratory wall cabinetry, 30" high, 1,025 laminate, 6 doors 21 7 Linear feet of built-in laboratory base cabinetry, 2,800 L-shaped, 24" deep, 4" high backsplash, 4 -drawer, I drop-in dual sink, 33" x 5" x 22", stainless steel, single mixing faucet, plumbing 21 7 Linear feet of wall cabinctry, 30" high, laminate, 4 -door 725 22 1 Floor sink, recessed metal, metal grate top 1,000 23 1 Water heater, American, Model: Proline, 30 gallon 875 estimate, natural gas, with wood wall shelf, 24" x 24" 24 1 Lot of electrical setup and installation for dental vacuum 850 and compressor 2 75J-40 MODERN AGE DENTISTRY DBA AMERICAN SMILE FAMILY DENTISTRY IMPROVEMENTS PERTAINING TO THE REALTY EFFECTIVE DATE OF VALUE - OCTOBER 15, 2015 Fair Market Item Value ill No. Qty. Description Place 25 1 Lot of subterranean dental plumbing for air, water and 6,150 suction to 4 operatory rooms, estimated at 3/4" PVC/coppor, including I I£leen Plus water filter and 4jookoy boxes and connections to dental chairs 26 1 Built-in wall cabinet, 38" x 91" x 20", laminate, 4 upper 775 .tiers, I base cabinet, 2 -door 27 1 Built-in wall shelf, 34" x 91" x 12", laminate, 7 -tier 540 28 1 Lot of data cabling and computer networking tbru-out for 1,200 8 workstations, including wall jacks 29 2 Cabinets, Tx Thigh, 2 -door, 6 -tier, laminate 860 30 1 Lot of electrical connections, setup and installation for 1,500 4 operatory/ dental chairs 31 1 Lot of setup, installation and wall mounting for 2 intra- 1,125 oral x-ray units TOTAL IMPROVEMENTS PERTAINING TO TAE REALTY $56„025 Note: The following leasehold improvements were installed by the lessee. They are included in the related real estate appraisal report,, therefore, they are not included herein in order to avoid duplication of compensation. • Interior wall partitioning and doors • Vinylfloorcovering 11 75J-41 Epic Land Solutions, Inc. 40101 2601Airport drive, Suite 130 Torrance, CA 90SOS Phone: (3;1.0)986-2960 Fax: (310)891-3348 CITY OF SANTA ANA TITLE VI INFORMATION PACKAGE The prgject proposed by the agency listed above will be receiving:fedcral financial assistance. Pursuant to Title VI of the Civil Rights Act of 1964, no person in the United States shall, oil, the grounds of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance. Other statutes provide protection against discrimination on the basis of sex, age or disability, The enclosed Title VI package is being provided for your information to further explain your rights. The Packageincludes the following documents: • Title VIBooldet • Title VI of the 1964 Civil Rights Act and Related Statutes • Right of Way Title VI Survey Form with Self -Addressed Stamped, Envelope • Right of Way Title VI Discrimination Complaint Form • The 11S. Department of Commerce Census Bureau, Language Identification Flashcard It is requested the Right of Way Title VI Survey form be completed and returned in the self addressed stamped envelope. If you read or speak a language different than English, please write your name and address on the top of the page and check the appropriate box on. the Language Identification Flashcard; or, if you. believe you have been subjected to discrimination, please fill out the Right of Way Title VI Discrimination Complaint form and return to the following: Jason Gabriel Principle Civil Engineer City of Santa Ams 20 Civic Center Plaza M-36 Santa Ana, CA 92702 CREATING LAND SOLUTIONS FOR THE PUBLIC GOOD www.CplcLand,com 75J-42 LU O > _S z n 0 00 42 OEI m a. i @ a M oU 00 Z D o �y N N L m u o W=0O Uii.v ONQ�O�d-iOui v _Ow oSue m VIOa 0c� On cm �guoim L`fdr.�Nq Ova �Ow m. in `G .�°i.. �n 4c q? a± N pkpn. ,O rvr C� Q O I'r V OO _� 0Ow 0w "0�O'• .?4C�uL. V rmcn+ 75J-43 :t7 4 NY M1. C> O O ww C b u O C -d '6n G l.� -il U -d 'G _ U Y O a in Y? v W G 0� .h v' �.. a ,Y o c a E a .n ro .v ro Gao o a. o' y ,-S o o E c .S ed v o �' 'a o ¢ r9< .� t rti w o 03 w 17J bb 0 "'iO3l0 J, N•ro N OU v[ a •lu '�.Ca.(U�" Ii .Yo ba uvrFi, -uM �2 O.Y=GOyua cw�b.,aYoau ? o, o ° ` °c ;o °" ao u b 'o o W f m �E . o> . °L01oov> o O. O o U y(m 1" 'r i,O o Y b .Eb o Q `> hg, } 0 : .ov ao o ° ti,, p av mkE c $� E o ° i cm d ° ai a O '' 7• 4 m f" o u o u o m� o n n 'O. j= tj ° •E r C by m o a= >° •2 A b Z A � o to l.J L A > F Ll � +�" �. �"n �' E iR ww tj = m u c G a E t, p OC C3 v 3 b o •� b •G m a { ' yy�� E[,_ --�� L � ��C11011 (j 01 N YilCG V O A. 4A 4 � F -a 'F E [n` `ci a Li Va '� a O Y ,�. �. a � � �- Y �--qq" m .• ;C .Zia E w..� - bd .W `'1 a .c� � �„ o •3 o U Y° .R c v D rn°"TMr_.,.,. ro c u '°G ii u v °u c '.,n'c c,.�, -o `o .$ °, o a fl: •3 v c v °•. 5 E o c 'c a E 6 E F u$ o o: E v r a v° o- .� -an 'G • u ro° c E •o a w •c a �' > `w u a .�..= n�', = t-' r c n..� >° c 'S c o o U°° U w'� o U 75J-44 VS oa `ct a 0 tY o a rl O ti r4 i a G S CY lSY" W, A, 75J-44 TITLE VI OF THE 1964 CIVIL RIGHTS ACT AND RELATED STATUTE Noe 1 of 2 NONDISCRIMINATION STATUTES • Title VI of the 1964 Civil Rights Act, 42 U.S.C. 2000, provides in Section 601 that: "No person in the United States shall, on the ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance." (PROHIBITS DISCRIMINATION IN IMPACTS, SERVICES, AND BENEFITS OF, ACCESS TO, PARTICIPATION IN, AND TREATMENT UNDER A FEDERAL-A1D RECIPIENT'S PROGRAMS OR. ACTIVITIES) The.Age Discrimination Act of 1975, as amended 42 U.S,C. 6101, provides: "No person in the United States shall, on the basis of age, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance." (PROIIIBITS DISCRIMINATION BASED ON AGE) • The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, 42 U.S.C. 4601, provides: "For the fair and equitable treatment of persons displaced as direct result of programs or projects undertaken by a Federal agency or with Federal fmsescial assistance." (PROVIDES FOR FAIR TREATMENT OF PERSONS DISPLACED BY FEDERAL AND FEDERAIrAF) PROGRAMS AND PROJECTS) • The Federal -aid Highway Act, 49 U.S.C. 306 Outlines the responsibilities of the U.S, Department of Transportation and, at (c) outlines the Secretary's authority to decide whether a recipient has net compiled with applicable Civil Rights statutes or regulations, requires the Secretary to provide notice of the violation, and requires necessary action to ensure compliance. • The 1973 Federal -aid Highway Act, 23 U,SC. 324, provides: "No person shall on the ground of sex be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal assistance under this Title or carried on under this title." (PROHIBITS DISCRIMINATION ON THE, BASIS OF SEX) • The Civil Rights Restoration Act of 1987, P,L. 100-209, provides: Clarification of the original intent of Congress in Title VI of the 1964 Civil Rights Act, Title DC of the Education Amendments of 1972, the Age Discrimination Act of 1975, and Section 504 of the Rehabilitation Act of 1973. (RESTORES THE BROAD, INSTITUTION -WIDE SCOPE AND COVERAGE OF THE NON-DISCRIMINATION STATUTES TO INCLUDE ALL PROGRAMS AND ACTIVITIES OF FEDERAL -AID RECIPIENTS, SUB -RECIPIENTS AND CONTRACTORS, WHETHER SUCH PROGRAMS AND ACTIVITIES ARE FEDERALLY ASSISTED OR NOT) • The Uniform Relocation Act Amendments of 1987, P.L. 101-246, provides: "For faii, uniform, and equitable treatment of all affected persons; ..,(and) minimizing the adverse impact of displacement ... (to maintain)... the econonde and social well-being of communities; and ... to establish a lead agency and allow for State certification and implementation." (UPDATED THE 1970 ACT AND CLARIFIED THE INTENT OF CONGRESS IN PROGRAMS AND PROJECTS WHICH CAUSE DISPLACEMENT) 75J-45 TITLE VI OF THE 1964 CIVIL RIGHTS ACT AND RELATED STATUTES Page2of2 The Americans with Disahfiities Act, P.L. 101-336, provides: "No qualified individual with a disability shall, by reason of such disability, be excluded from the participation in, be denied benefits of, or be subjected to discrimination by a department, agency, special purpose district, or other instrumentality of a State or a local government," (PROVIDED ENFORCEABLE, STANDARDS TO ADDRESS DISCRIMINATION AGAINST PEOPLE WITH DISABILITIES) " The Civil Rights Act of 1991, inpart, amended Section 1981 of 42 U.S.C. by adding two new sections that provided: "(b) For the purposes of this section, the term `make and enforce contracts' includes the making, performance, modification, and termination of contracts and the enjoyment of all benefits, privileges, terms, and conditions of the contractual relationship. (c) The rights protected by this section are protected against impartment by non-governmental discrimination and impairment under color of State law." • Title VIII of the 1968 Civil Rights Act, 42 U.S.C. 3601, provides that: "(I) It shall be unlawful ... to refuse to sell or rent after the making of a bona fide offer, or to refuse to negotiate for the sale or rental of, or otherwise make unavailable or deny a dwelling to any person because of race, color, religion or national origin." (PROHIBITS DIS CRWINATION IN THE SALE OR RENTAL OF HOUSING — FlUD is the primary interest agency, but FHWA and States under Title VI are responsible for preventing discrimination in the function of Right -of Way) • The Nall onal Environmental Policy Act of 1969, 42 U.S.C. 4321 Requires the consideration of alternatives, including the "no -build" alternative, consideration of social, environmental and economic impacts, public involvement, and use of a systematic interdisciplinary approachat each decision making stage of Federal -aid pxoject development. • Title DY of the Education Amendments of 1972 Makes financial assistance available to institutions of higher education to: (1) strengthen, improve and, where necessary, expand the quality of graduate and professional programs leading to an advanced degree; (2) establish, strengthen, and improve programs designed to prepare graduate and professional students for public service; and (3) assist in strengthening undergraduate programs of instruction in certain instances. • Section 504 of the Rehabilitation Act of 1973,29 U.S.C. 790, provides that: "(N)o qualified handicapped person shall, solely by reason of his handicap, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under anyprogram or activity that receives or benefits from Federal financial assistance." (PROHIBITS DISCRIMINATION BASED ON PIIYSICAL OR MENTAL HANDICAP) Source: U.S. Department of Transportation Federal Highway Administration Title VI Handbook Title VI Nondiscrimination in the Federal -Aid Highway Program FHWA Publication No. FHWA-HCR-06-006 75J-46 TITLE VI SURVEY PRRSONAL INFORMATION NOTICE Pursuant to the Federal Privacy Act (P.L. 93-579) and the Information Practices Act of 1977 (Civil Code Sections 1798, et seq), notice is hereby given for the request of personal information by this form. The requested personal information is voluntary. The principal purpose of the voluntary information is to facilitate the processing of this form. The failure to provide all or any part of the regnested information may delay processing of this form. No disclosure of personal information will be made unless permissible under Article 6, Section 1798.24 of the IPA of 1977. Eachindividual has the right upon request and proper identification, to inspect all personal information in any record maintained on the individnal by an identifying particular. Direct any inquiries on information maintenance to your IPA Office. Expenditure Authorization (EA) NON-DISCRZ41NA.TION All persons affected by State transportation projects are requested to provide information with regard to race, color, national origin, sex, disability, age or income status. Please clreck the items below which hest describe you and return this form in the enclosed envelope. The furnishing of this information is voluntary. Head of household: Male Female Age: ^ Under 4C u 41-65 _ Over 65 RaceSthnicity: _ White _ American Tribe Black Pacific Islander _Hispanic _ Other _ Asian Language spoken, if other than English: Specify: Are you or any member of your household suffering any physical disability or medical condition? _ Yes —No Are you a low-income fatally? _ Yes —No Enclosure 75J-47 TITLE VI DISCRIMINATION COMPLAINT PERSONAL INFORMATION NOTICE Pursamt to Iho Fodaml Privacy Act (P.L. 93L79) and the Incerallor, Practices Act of IB77 (CNII Code Seasons 179a, at Beg.), notice Is hereby given for the request of monemml informatlm by this form. The requested personal let ...do. is voluntary. The principal traumas ofthe voluntary Information is to facililata Ilea aemse ing of this learn. The failure to provide all or any part of the aquesied Infmmatien may delay processing of Ihia fomt. No disclosure of remnant infomation Whir be made unless parmis,lble under Article B, Basilan 1709.24 of the IPA of 1W7. Each individual hoe ileo of,, upan roquasl end paper Identification, to Inspect ell Pomona] infmmatlon In any reco d maintained on the IndfAc e.l by as Identifying particula, eireci any Inquides on Hfomatlon malnlenanes to your IPA Office. Dist Co BASIS OF DISCRIMINATION Rte Post ❑ RACE ❑ COLOR ❑ NATIONAL ORIGIN ❑ SEX ❑ Diabihty ❑ Low -Income ❑ Non-English Speaker Provide data(s) and pita.. of alleged discrimination Describe thenature of the action, decision, or conditions of the alleged discrimination (Attach Extra Page. If Necessary) Name of individuals (if Known) responsible for the action, decision or condition of alleged discrimination Provide supporting informatieu known to complainant in support ofbis/her allegation Identify possible witnesses whom the complainant believes can provide factual information about this allegation State the action requested by complement 75J-48 ,"a�� 11 ,U„„•; yi i>"s; u:+s I.ilLayll I:La �a �Sl� �.,� i�'iarttimal' 41 e Sa Lna.rl' ttruanwtt,@ / lv,�i wJu Eafdh �uownrd' Ipdnl' Ilaerl tauP bwJLpkSr: dlfyfStiCnlfil il�SS&£iSt6 SU& �i to U§w1wrium that `I -- ® Moth i kahhon ya yaugin Qntangnu' manaitai pat flntOngnu' kanteutos Chamorro. ?1KI�fi1�'i'tjn'4����'C�li�•��a 1� ��Jl(;'��.r — Oznaoite ovaj kvadratic AD Sitate ili govorite hrvatski jezik, 0 ZaMutnke tato kolonku, poked etete a hovoifte cesky. l Kruis flit valcje sea als u Nederlands kraut lezen of sproken. �J El 'Mark this box if you read or speak Fngfish. El ..0 , C��Ap 1j fir° `y1 c l «M a al �tb u w9 s p my �I Cvmimnlos andsA UR U.S. CENSUSSURVAU 75J-49 1. Arabic 2. Armenian 3. Bengali 4. Cambodian 5. Chamorro 6. Simplified Chinese 7.Traditional Chinese 8.Croatian 9. Czech 10. butch 11. English 12. Farsi ❑ Cocher ici si vous lisez ou patlez In frangais. ❑ Kreuzen Sin diesel Kastchen an, wenn Sic Deutsch lesen oder sprechen. ❑ Ehµetwore auto to n? aioto av Simi&t ere'1 µl? ate EAItivix&. ❑ Make kazye sa a si ou h oswa ou pale kreyBl ayisyen. fHaiwt7itr tF5�r za w wqicr er cls' im zffFf rFT ftv F70 I Kos lub voj no yog koj paub twm thiab pais lus Hmoob. F 3elolje meg ezt a kock5t, ha megezti vagy beszeli a magyar nyelvet. [[:'Maikaain daytoy nga kation no makabasa wmao makasaoka iti Uocano. r Marchi questa Casella se leggc o parts Italiano, ❑ 024-18: kvtl�J trot of ��l��p l�l7zG Leo ❑ al-�i z z-� 714 z1--Ij�T x RAI* t� h� . ❑ 2m"U1jgUU esu j�u�ue�u l�nw�a�a�o. ❑ Prosimy o zaznaczenie Lego kwadtatu, jeaeli posiugaje sie PanlPani jgzykiem polskim. DB�Ros U.S. DEPARTMENT OF COMMERCE EeommnleP vtid g +tMles AJmlht 4 tion U.S, CENSUS BUREAU 75J-50 13, French 14. German 15. Greek 16. Haitian Creole 17, Hindi 18. Hmong 19. Hungarian Im1. .I• 21. Italian 22.Japanese 23. Korean 24. Laotian 25. Polish ❑ Assinale este quadrado se voc816 ou fala portugues. 6emnali aceasta casuja daca ciflli sau voibiti romanesste. ❑ IToAsea Te sTOT xuappaTea<, eciar Em =rplw( Te inm roRopwa no-pyceim. ❑ O6enex<xTe osaj xnagpTrxh yxonmrco �IxTare xnx ronopxTe cpncxvr jesxrc. Oznacte tento stvor6ek, ak viete 6ftaf alebo hovorif po slovensky. ❑ Marque esta casilla si lee o habla espanol. ❑ Mat'kahan itong kuwadrado kung kayo ay marunong magbasa o magsalita ng Tagalog. ❑ `ltimtesnatiiat�ufla`ludosci�vi�uo�uuiolyfln�rr�"lwe�, ❑ Maaka `i he puha ni kapau'oku ke Ian pe lea fakatonga. ❑ Hix,fi r,Te igo zcitiTxmcy, mcap ex =aeTe a6o rosopxxe yrspa4tevxoFo mtoaoto. ��UlJ4I1_bvlr) �LZ- 1�111 r ❑ Xin danh dais vao 6 nay nett qu j vi hiet Hoc va n6i dufgc Viet NgfT. ❑ VM)N a7vT VIN UV57» 'roN viN 5uovp wl u»»NN2 uc•a,run 75J-51 V y 2conomlce and SNOA.c aammi:tntlo U.S. CENSUS 9UREAU 26. Portuguese 27. Romanian 28. Russian 29. Serbian 30. Slovak 31. Spanish 32.Tagalog 33, Thai 34,Tongan 35. Ukranian 36. Urdu 37.Vietnamese 38.Yiddish Form W - Request for Taxpayer Give Form to the (Rev. Decamber 2014) Identification Number and Certification entitles, it is your employer identification number (EIN). If you do not have a number, see How to get a requester. Do not Department of the Treasury TIN on page 3. Send to the IRS. Internal Revenue Service I Name (as shown on your Income tax return). Name is required on this line; do not leave this fine blank. ci 2 Bueiness name/dlaregarded entity name, If different from above w 3 Check appropriate box for federal tax classification; check only one of the following seven boxes: 4 Exemptions (codes apply only to ° ❑ Individual/sole proprietor or ❑ C Corporation p ❑SGerporation ❑ partnership ❑TrusVestate t indi certain entities, not individuals; see v single -member LLC insiructionson poge 31: ❑ Limited liability company. Enter the tax classification (CmC corporation, 5=3 corporation, P=partnership) ✓ Exempt payee code (If any) `o Nota. For a single -member LLC that Is disregarded, do not check LLC; check the appropriate box in the line above for Exemption from FATCA reporting r the tax classification of the single -member owner. code Of any) 5 p, G ❑Other (see lnatYGG110ne) (,1ppAeamaerounm mafntamNauftlCa m. us.) K S Address (number, street, and apt. or suite no.) Raqueater's name and address (optionag G N d re B City, state, and ZIP code W on 7 List account mannerist here(optionalt Miff Taxpayer Identification Number (TIN) Enter your TIN In the appropriate box. The TIN provided must match the name given online 1 to avoid Social security number For Individuals, this is generally your social security number (page However, for a backup wlien, sole resident alien, sole proprietor, or disregarded entity, see the par[ I Instructions on page 3. For other entitles, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. or Note. If the account Is In more than one name, see the Instructions for line 1 and the chart an page 4 for I Employer identification number guidelines on whose number to enter. j—I— F—T-7—T—F Under penalties of perjury, I certify that: 'I. The number shown on this form Is my correct taxpayer Idontlfft atlon number (or I am waiting for a number to be Issued to me); and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Servlce (IRS) that I am subject to backup withholding as a result of a failure to report all Interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and S. I am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA codes) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification Instructions. You must cross out Item 2 above If you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, Item 2 does not apply, For mortgage Interest paid, acqulsltion or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than Interest and dividends, you are not required to sign the certhIcatlon, but you must provide your correct TIN. See the Instructions on page 3. zsignI Signature of Here U,S. person t Date General Instructions Section references are to the internal Revenue Cade unless otherwise noted. Future developments. Information about developments affecting Form W-9 (9acli as legislation enacted after we release It) Is at rvacwha,bov)/WD. Purpose of Form An Individual or entity (Form W-9 requester) who Is required to file an Information return with the IRS must obtain your correct taxpayer Identification number (TIN) which may be your social security number (SSN), individual taxpayer Identification number(ITIN), adoption taxpayer Identification number (ATI N), or employer Wen Wron ing number (AN), to report on an Information return the amount paid to you, or other amount I'epohable on an information return. Examples of information returns Include, but are not limited to, the following: • Form 1099 -INT (Interest earned or paid) • Form 1099 -DIV (dividends, Including those from stocks or mutual funds) • Form 1099-MISC (various types of Income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Farm 1099-5 (proceeds from real estate transactions) • Form I OWK (merchant card and third party network lmnaactlons) • Form 1098 (home mortgage Interest), 1098-E (student loan interest), 1098-T gulllon) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Farm W-9 only If you are a U.S. person (Including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What /s backup withholding? on page 2, By signing the filled -out form, you: 1. Codify guards, TIN you are giving Is correctleryou are waiting for a number to be Issued), 2. Certify That you are not subjact to backup withholding, or 3. Glalm exemption from backup withholding If you are a U.S. exempt payed If applicable, you are also codifying that as a U.S. person, your allocable share of any partnership Income from a U.S. trade or business Is not subject to the withholding tax on foreign partners' share of effectively connected Income, and 4. Certify that FATCA come(s) entered on this form (if any) indicating that you aro exempt from the FATCA reporting, is correct. See Whatis FATCA reporting? on page 2 for further Information. Cat, No. 10231X 75J-52 Form W-9 (Rev. 12.2014) Farm W-9 (Rev, Note. If you are a U.S. parson and a requester gives you a form other than Form W-9 to request your TIN, you must use the requester's form If it Is substantially similar to this Farm W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person If you am: • An individual who Is a U.S. citizen or U.S. resident alien; • A partnership, corporation, company, or association created or organized In the United States or under the laws of the United States; • An estate (other than a foreign estate); or • Adomestic trust (as defined in Regulations section 301.7701-7). Special rules far partnerships. Partnerships that conduct a trade or business In the United States are generally required to pay a withholding tax under section 1446 an any foreign partners' share of effectively connected taxable Income from such business. Further, in certain cases where a Fool) W-8 has net been received, the rules under section 1446 require a partnership to Fractions that a partner la a foreign person, and pay the section 1443 withholding tax. Therefore, if you are a U.S. parson that Is a partner In a partnership conducting a trade or business In the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid section 1446 wRhhelding on your share of partnership income. In the cases below, the fallowing person must give Form W-9 to the partnership for purposes of mlabllshing Its U.S. status and avoiding withholding on its plausible shere of net income from the partnership conducting a trade or business In the United States: • In the case of a disregarded entity with a U.S. owner, the U.S. owner of the disregarded entity and not the entity; • In the case of a grantor trust with a U.S. grantor or other U.S. owner, generally, the U.S. grantor or other U.S. owner of the grantor It and not the trust; and • In the case of a U.S. trust (other than a grantor trust), the US. frust (other than a grantor trust) and hot the beneficiaries of the trust. Foreign person. If you are a foreign pemon or the U.S, branch of a foreign bank that has elected to be treated as a U.S. person, do not use Farm W-9. Instead, use the appropriate Form W-8 or Form 3233 (see Publication 515, Withholding of Tax on Nonresident Aliens and Foreign Entities). Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S, tax on certain types of Income. However, most tax treaties contain a provision known as a "saving clause." Exceptions specified in the saving clause may permit an exemption from tax 10 continue for certain types of Income even ater the payee has otherwise become a U.S. resident alien for tax purposes. If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a lax treaty to claim an exemption from U.S. tax on certain types of Income, you must attach a Statement to Form W-9 that specifies the following five Items: 1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien. 2. The treaty article addressing the Income. 3. The edlele number (or location) In the tax treaty that contains the saving clause and Its exceptions. 4. The type and amount of Income that qualities for the exemption from tax. 5. Sufficient facts to justify the exemption from tax under the terms of the treaty article. Example. Article 20 of the LLS. -China Income tax treaty allows an exemption from tax for scholarship Income received by a Chinese student temporarily present in the United States, Under U.S. law, this student will become a resident alien for tax purpo see If his or her stay In the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30, 1934) allows the provisions of Allots 20 to continue to apply even after the Chinese student becomes a resident alien of the Unlled Slates. A Chinese student who qualities for this exception (under paragraph 2 of the first protocol) and is relying an this exception to claim an exemption from tax on his or her scholarship or fellowship income would attach to Form W-9 a statement that Includes the Information described above to support that exemption. If you are a femossident alien or a foreign entity, give the requester the appropriate completed Form W-8 or Form 8233, Backup Withholding What is backup withholding? Persons making certain payments to you must under cedain conditions withheld and pay to the IRS 281/a of such payment¢. This is called "backup withholding." Payments that may be subject to backup withholding Include Interest, lax -exempt Interest, dividends, broker and barter exchange transactions, rents, royallles, nonemployee pay, payments made In settlement of payment card and third party network transactions, and certain payments from fishing beat operators. Real estate transactions at not subject to backup withholding. You will net be subject to backup withholding on payments you receive If you give the requester your correct TIN, make the proper certifications, and report all your taxable Interest and dividends on your tax return. Payments you receive will be subject to backup withholding if: 1. You do not furnish your TIN to the requester, 2. You do not certify your TIN when required (see the Pad Il Instructions on page 3 for details), Page 2 3. The IRS tells the requester that you furnished an Incorrect TIN, 4, The IRS tells you that you are subject to backup withholding because you did not report all your interest and dividends an your lax return (for reparable Interent and dividends only), or 5. You do not certify to the requester that you are not subject to backup withholding under 4 above (for reportable Interest and dividend accounts opened star 1983 only-). Certain payees and payments are exempt from backup withholding. Sea Exempt payee code on page 3 and the separate Instructions for the Requester of Form W-9 for more information. Also see Special rules for partnerships above. What is FATCA reporting? The Foreign Account Tax Compliance Act (FATCA) requires a parllcipatng foreign thermal Institution to report all United States account holders that are specified United States persons. Certain payees are exempt from FATCA reporting. See Exemption from FATCA reporting code on page 3 and the Instructions for the Requester of Form W-9 for more Information. Updating Your Information You must provide updated Information to any person to whom you claimed to be an exempt payee If you are no longer an exempt payee and anticipate receiving reportable payments in the future from this parson. For example, you may need to provide updated information If you are a C corporation that elscts to be an 5 corporation, or Ifyou no longer are tax exempt. In addition, you must furnish a new Form W-0 If the name or TIN changes for the account; for example, It the grantor of a grantor trust dies. Penalties Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are subject to a penalty of $50 for each such failure unless your failure is due to reasonable cause and not to willful neglact. Civil penalty for false Information with respect to withholding. If you make a false statement with no reasonable basis that results In no backup withholding, you are subject to a $500 penalty. Criminal penalty for falsifying Information. Willfully falsifying certifications or off iterations may subject you to criminal penalties Including lines and/or imprisonment. Mimme of TINS. If the requester discloses or uses TlNs in violation of federal law, the requester may be subject to clvll and criminal penalties. Specific Instructions Line 1 You must enter one of the fallowing on this line; do not leave this line blank. The name should match the name on your tax return. If this Form W-9 is for a joint account, list first, and than circle, the name of the person or entity whose number you entered In Pen I of Form W-9, a. Individual. Generally, enter the name shown on your tax return. If you have changed your last name without informing the Social Security Administration (SSA) of tha name change, anter your first name, the last name as shown on your social security card, and your new Iasi name. Note. In applicant. Enter your Individual name as It was entered on your Form W-7 application, line 1a. This should also be the same as the name you entered on the Form 1040/104OA/1040EZ you filed with your application. R. Sole proprietor or single -member LLC. Enter your individual name as shown on your 104011040AII 040EZ on line 1. You may enter your business, trade, or "doing business as" (DBA) name on line 2. a, Partnership, LLC that is not a single -member LLC, C Corporation, or S Corporation. Enter the entity's name as shown on the entity's tax return on line 1 and any business, trade, or DBA name on line 2. d. Other entitles. Enter your name as shown on required U.S. federal tax documents on line 1. This name should match the name shown on the charter or other legal document creating the entity. You may enter any business, trade, or DBA name on line 2. e. Disregarded entity. For U.S. federal tax purposes, an entity that Is disregarded as an entity separate from Its owner is treated as a "disregarded entity," Sea Regulations section 301.7701-2(c)(2)(10). Enter the owner's name on line 1. The name of the entity entered on line 1 should never be a disregarded entity. The name on line 1 should be the name shown on the Income lax return on which the Income should be reported. For example, if a foreign LLC that is treated as a disregarded entity for U.S. federal tax purposes has a single owner that is a U.S. person, the U.S, owner's name Is required to be provided on line 1. If the direct owner of the entity is also a disregarded entity, enter the first owner that Is not disregarded for federal tax purposes. Enter the disregarded entity's name on line 2, "Business nameldisregarded entity name." if the owner of the disregarded entity is a foreign person, the owner must complete an appropriate Form W-8 Instead of a Form W-9, This Is the case even If the foreign person has a U.S. TIN. 75J-53 Farm W-9 (Rev. 12-2014) Line 2 If you have a business name, trade name, DBA name, or disregarded entity name, you may enter It on line 2. Line 3 Check the appropriate box In line 3 for the U.S. federal tax classification of the person whose name Is entered an tine 1. Check only one box inline 3. Limited Liability Company (LLC), If the name on line 1 Is an LLC treated as a partnership for U,S. federal tax purposes, check the "Limited Liability Company" box and enter "P" in the space provided. If the LLC has Bled Form 8832 or 255310 be taxed as a corporation, check the "Limited Liability Company' box and In the space provided enter "C" for C corporation or "S" for S corporation. If It Is a single -member LLC that is a disregarded entity, do not check the "Limited Liability Company" box; instead check the first box in line 3 "IndriduaUsole proprietor or single -member LLC." Line 4, Exemptions If you are exempt from backup withholding and/or FATCA reporting, enter In the appropriate apace In line 4 any code(s) that may apply to you. Exempt payee code. • Generally, Individuals (including sole proprietors) are not exempt from backup withholding. • Except as provided below, corporations are exempt from backup withholding for certain payments, including Interest and dividends. a Corporations are not exempt from backup withholding for payments made In settlement of payment card or third party network transactions, • Corporations are not exempt from backup withholding with respect to anameys' fees or gross proceeds paid to attorneys, and corporations that provide medical or health care services are not exempt with respect to payments reportable on Farm 1099-MISC. The following codes Identify payees that are exempt from backup withholding. Enter the appropriate code In the space In line 4. 1—An organization exempt from tax under section 50 Its), any IRA, or a custodial account under section 403(b)(7) If the account satinfles ins requirements of section 401((/(2) 2—Tho United States or any of Its agencies or Instrumentalities 3—A state, the Distant of Columbia, a U.S. commonwealth or possession, or any of their political subdivisions or Instrumentalities 4—A foreign government or any of its political subdivisions, agencies, or Instrumentalities 5—A corporation 6—A dealer In securities or commodities required to register In the United Stales, the District of Columbia, or a U.S. commonwealth or possession 7—A futures win mission merchant registered with the GolTlmodlty Futures Trading Gommlsslon e—A real estate Investment trust 9 —An entity mgletered at all times during the tax year under the Investment Company Act of 1940 10—A common trust fund operated by a hank under section 51 11—A financial institution 12—A middleman known In the Investment community as a nominee or custodian 13--A trust exempt from tax under section 664 or described In section 4947 The following chart shows types of payments that may he exempt from backup withholding. The chart appllea to the exempt payees listed above, 1 through 13. IF the payment is for... THEN the payment is exempt for... Interest and dividend payments All exempt payees except for 7 Broker transactlons Exempt payees I through 4 and 6 through 11 and all C corporations. S corporations must not enter an exempt payee code because they are exempt only for sales of noncavared securities acquired prior to 2012. Parte) exchange transactions and Exempt payees 1 through 4 patronage dividends Payments over $600 required to be Generally, exempt payees reported and direct &nice aver $5,0001 1 through 5' Payments made In settlement of Exempt payees 1 through 4 payment card or third party network transactions 1 See Farm 1099-MISC, Mlseelleneous Income, and Its Instructions. 'However, the following payments made to a corporation and reportable on Form I090-MISO are not exempt from backup withholding: medical and health care payments, attorneys' fees, gross proceeds paid to an attorney reportable under section 61 and payments for services paid by a federal executive agency. Exemption from FATCA reporting code, The following codes identify payees that are exempt from reporting under FATCA. These codes apply to persons submitting this farm for accounts maintained outside of the United States by certain foreign financial Institutions. Therefore, if you are only submitting this form for an account you hold In the United States, you may leave this field blank. Consult with the person requesting this form if you are uncertain if the financial institution is subject to these requirements. A requester may Indicate that acode is not required by providing you with a Form W-9 with "Not Applicable" (or any similar Indication) written or printed on the line for a FATCA exemption code. A—An organization exempt from tax under section 501(a) or any Individual retirement plan as defined in section 7701(a)(37) B—The United States or any of its agencies or Instrumentalities C—A state, the District of Columbia, a U.S, commonwealth or possession, or any of their political subdlvisions or instrumentalities D—A corporation the stock of which is regularly traded on one or more established securities markets, as described In Regulations section 1.1472-1(c)(1)(I) E—A corporation that is a member of the same expanded affiliated group as a corporation descnbed in Regulations section IA472-1(c)(1)O F—A dealer In securities, commodities, or derivative financial Instruments (including notional principal contracts, futures, forwards, and options( that Is registered as such under the laws of the United States or any stale G—A real estate Investment trust H—A regulated Investment company as defined in section 851 or an entity registered at all times during the tax year under the Investment Company Act of 1940 I—A common trust fund as defined In section 584(a) J—A bank as defined In ...flan 581 K—A broker L—A trust exempt from tax under section 664 or described In section 4947(a)(1) M—A tax exempt Gust under a section 403(b) plan or section 457(g) plan Note. You may wish to consult with the financial institution requesting this form to dommilne whether the FATCA code and/or exempt payee coda should be completed. Line 5 Enter your address (number, street, and apartment or suite nunihary. This Is where the requester of this Form W-9 will mall your Information returns. Line 6 Enter your city, state, and ZIP code. Part I. Taxpayer Identification Number (TIN) Enter your TIN In the op proprlsts box, If you are a resident alien and you do not have and era not eligible to get an $SN, your TIN Is your IRS individual taxpayer Iwritifioation number (ITIN). Enter it in the social security number box. If you do not have an ITIN, see How to gat a TIN below. If you are a sole proprietor and you have an FIN, you may enter either your SSN or FIN. However, the IRS prefers that you use your SSN. If you are a single -member LLC that Is disregarded as an entity separate from its owner (see Limited Liability Company (LLC) on this page), enter the owner's SSN (or EIN, if the owner has ane). Do not enter the disregarded ontlty's FIN. If the LLC is classified as a corporation or partnership, enter the entity's EIN. Note. See the chart on page 4 for further clarification of home and TIN combinations. How to get a TIN. If you do not have aTIN, apply for one immediately. To apply for an SSN, gat Form SS -5, Application for a Social Security Card, from your local SSA office or gat this farm online at www.ssa.gov. You may also get this form by calling 1-800-772-1213. Use Form W-7, Application for IRS individual Taxpayer Idehlification Number, la apply far an ITIN, or Form SS -4, Application for Employer Identification Number, to apply for an EIN. You can apply for an EIN online by accessing the IRS webslle at www.inogovlbuslaosses and clicking on Employer Identification Number (EIN) under Starting a Business. You can get Forms W-7 and SS -4 from the IRS by visiting IRS.gov or by calling 1 -800 -TAX -FORM (1-000-829-3670), If you are asked to complete Form W-9 but do not have a TIN, apply for a TIN and write "Applied For" In the space for the TIN, sign and date the form, and give it to the requester. For Interest and dividend payments, and certain payments made with respect to readily bsuable instruments, generally you will have 60 days to gel a TIN and give It to the requester before you are subject to backup withholding on payments. The 60 -day rule does net apply to other types of payments. You will be subject to backup withholding on all such payments until you provide your TIN to the requester. Note, Entering "Applied For" means that you have already applied for a TIN or that you Intend to apply for one soon. Caution: A disregarded U.S. entity that has a Poreign owner most use the appropriate Farm W -a. 75J-54 Farm W-9 (Rev. 12-20141 Part If. Certification To establish to the withholding agent that you are a U.S. person, or resident alien, sign point You may be requested to sign by the withholding agent even if Items 1, 4, or below Indicate otherwise. Fora joint account, only the person whose TIN Is shown in Part I should sign (when required). In fhe case of a disregarded entity, the person identified on line I most sign. Exempt payees, see Exempt payee code cath at, Signature requirements. Complete the certification a. Indicated in Items 1 through 5 below. 'I. Interest, dividend, and barter exchange accounts opened before 1084 and broker accounts considered active during 1883. You must give your correct TIN, but you do not have to sign the cetiiffcation. 2. Interest, dividend, broker, and barter exchange accounts opened after 1983 and broker accounts considered inactive during 1883. You must sign the cer iflcalion or bae(fup withholding will apply. If you are subject to backup withholding and you. aro merely providing your correct TIN to the requester, you must cross cut Iteirm in the certification before signing the farm. 3. Real estate transactions, You most sign the certification. You may cross out item 2 of the .edification. 4. Other payments. You must give your correct TIN, but you do not have to sign the cedltication unless you have been notified that you have previously given an Incorrect TIN. "Other payments" Include payments made In the course of the requester's trade or business for rents, royalties, goods (other than bills for handbag lse), mantel and health care services (including payments to corporations), payments to a nonemployee for services, payments made In settlement of payment card and third party network transactions, payments to certain fishing boat area, members and fishermen, and gross proceeds paid to attorneys Occluding payments to corporation). S. Mortgage Interest paid byyeu, acquisition or abandonment of secured property, cancellation of debt, qualified tuition program payments (under section 629), IRA, Caverdell ESA, Archer MSA or HSA contributions or distributions, and pension distributions. You must give your cor set Tl N, but you do not have to sigh the codification. What Name and Number To Give the Requester For this type of ... cost: Give name and SSN ph 1. Individual The individual 2. Two or more Individuals Qoint The actual owner of the account or, account) if combined funds, the first Individual on the account' S. Custodian account of a minor The minor' (Uniform Gift to Minors Act) 4. a. The usual revocable savings The greeter -trustee' imst (grantor Is also trustee) b. So-called trust account that Is The actual owner' not a legal or valid trust under state law 5. Solo propriat... hip or disregarded The owner' entity owned by an Individual S. Grantor trust filing under Optional The grantor' Form 1098 Filing Method 1 (see Regulations section 1.871-4(b)(2)(f) (A)) For this type of account: Give name and EIN of: 7. Disregarded entity not owned by an The owner individual 8. A valid trust, estate, or pension trust Legal entity` 9. Corporation or LLG electing The corporation corporate status on Form 8932 or Form 2553 10. Association, club, religious, The organization charitable, educational, or other tax- exempt organeatlon 11. Partnership or multi -member LLG The partnership 12. A brokeror registered nominee The broker or nominee 13. Account with the Department of The public entity Agriculture In the name of a public entity (such as a state or local government, school district, or prison) that receives agricultural program payments 14. Grantor trust filing under the Form The trust 1041 Flling Method or the Optional Form 1099 Flling Method 2 (see Regulations section 1.671-4(b)(2)(1) (e)1 fist first and sirda the name of the person whose number you fu lab. II only one comes ora joint account has an SSN, that person's numbermust he furnished. a Circle the manor's name and furnish the minm'r SSN. You must show your Individual name and you may also enter your business or boAnrme on the "northern name/dlsregzrded orally" name Ilne. You may use either your SSN or EIN Of ycu have one), but the IRS encourages you to use your SSN. List boat end circle the name of the trual, eslals, or pension treat, (Do not furnish the TIN of the personal representative or hurter matron the legal entity itself Is not designated In the account MIST Also ere Special rules for padneRhlps on page 2, -Nola. Grantor also net pmvide a Form W-91. trustor of test. Note. if he name Is circled when more than one name Is listed, the number will be considered to be that of the first name listed. Secure Your Tax Records from Identity Theft Identity theft occurs when Situation uses your personal Information such as your name, SSN, or other Identifying Information, without your permission, to commit fraud or other crimes. An identity thief may use your SSN to gel a fob or may file a tax return using your SSN to receive a refund. To reduce your risk; • Protect your SSN, • Ensure your employer Is protecting your SSN, and r Re careful when choosing a tare preparar. If your tax records are affected by Identity theft and you receive a notice from it IHS, respond right away to the name and phone number printed on the IRS notice or letter. If your tax records are not currently affected by Identity theft but you think you are at risk due to a lost or stolen purse or wallet, questionable credit card activity or credit report, contact the IRS Identity Theft Hotline at 1-800-900-4490 or submit Form 14039. For more Information, see Publication 4535, Identity Theft Prevention and Victim Assistance. Vletlms of identity (haft who are experiencing economic harm or a system problem'or are seeking help In resolving tax problems that have not been resolved through normal channels, may be eligible far Taxpayer Advocate Service grAS) assistance. You can reach TAS by calling the TAS toll-free case intake line at 1-077-777-4778 or Try/ Ph) 1 -800-820-4059, Protect yourself from suspicious emalls or phishing schemes. Finishing is the creation and use of small and websites designed to mimic legitimate business Smalls and websites. The most common act is sending an email to a user falsely claiming to be an established legitimate enterprise In an attempt to scam the user Into surrendering private Information that will be used for identity theft. The IRS does not Initiate contacts with taxpayers via emate, Also, the IRS does not request personal detailed Information through email or ask taxpayers for the PIN numbers, passwords, or similar secret access Information for their credit card, bank, ar other financial accounts. If you receive an unsolicited email claiming to be from the IRS, forward this message to phishing@lm.gov. You may also report misuse of the IRS name, logo, or other IRS property to the Treasury Inspector General for Tax Administration (TIGTA) at 1-500-368-4484. You can forward suspicious smalls to the Federal Trade Commission at: spamall gov or contact them at Svi legowldlheft or 1-ItTf-IDTHEFT (1.877.438-4338). Visit IArl to learn more about Identify theft and how to reduce your risk. Privacy Act Notice Section 6100 of the Internal Revenue Code requires you to provide your correct TIN to persons (including federal agencies) who are required to file Information returns with the IRS to report Interest, dividends, or certain other income paid to you; mortgage Interest you paid; the acquisition or abandonment of secured property; the cancellation of debt; or contributions you made to an IRA, Archer MGA, or HSA. The person collecting this for uses the information on the torp to file information returns with the IRS, reporting the above information. Routine uses of this Information Include giving It to The Department of Justice for civil and criminal litigation and to cities, states, the District of Columbia, and U.S. commonwealth. and possessions for use In administering their laws. The Information also may be disclosed to other countries under a treaty, to federal and state agencies to enforce doll and criminal laws, at to federal law enforcement and Inielllgenca agenates to combat terrorism. You must pmvide your TIN whether or not you are received to its a Not return. Under section 3406, payers must generally withhold a percentage of taxable Interest, dividend, and certain other payments to a payee who does hot give a TIN to the payer. Certain penalties may also apply for providing false or fraudulent information. 75J-55 6/20/17 RESOLUTION NO. 2017 -XXX A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SANTA ANA FINDING AND DETERMINING THAT THE PUBLIC INTEREST, CONVENIENCE AND NECESSITY REQUIRE THE ACQUISITION OF CERTAIN REAL PROPERTY LOCATED WITHIN THE CITY OF SANTA ANA AT 2209 S. BRISTOL STREET (APN 015-194-25) FORTHE BRISTOL STREET WIDENING PROJECT BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF SANTA ANA AS FOLLOWS: Section 1. On June 20, 2017, the City Council of the City of Santa Ana, after written notice duly provided to all those claiming ownership in the property described hereafter, as they appeared on the last equalized County assessment roll, held a hearing pursuant to Code of Civil Procedure section 1245.235 for the purpose of allowing the owners thereof a reasonable opportunity to be heard on the following matters: A. Whether the public interest or necessity requires the project; B. Whether the project is planned or located in a manner which is most compatible with the greatest public good and the least private injury; C. Whether the property proposed to be acquired is necessary for the project; D. Whether the offer required by Government Code section 7267.2 has been made; E. Whether the City has complied with all conditions and statutory requirements necessary to exercise the power of eminent domain to acquire the property described herein, as well as any other matter regarding the right to take said property by eminent domain; and Whether the City has statutory authority to acquire the property by eminent domain. Section 2. The City Council has, as a result of its consideration and the evidence presented at the hearings on this matter, and in accordance with the California Environmental Quality Act ("CEQA") and the State CEQA Guidelines, determined that the proposed project has been adequately evaluated in the previously prepared Environmental Impact Report/Environmental Impact Statement EIR No. 89-01 and all subsequent addenda. In accordance with National Environmental Policy Act, an Environmental Assessment document with a Finding of No Significant Impact was prepared for the proposed project and approved by the Transportation and Federal Highway Administration in 2011. Exhibit 3 75J-56 California Department of Resolution No. 2017 -XXX Page 1 of 6 On the basis of this review, the City Council finds that there is no evidence from which it can be fairly argued that the Project will have a significant adverse effect on the environment. Section 3. Pursuant to Title XIV, California Code of Regulations ("CCR") § 753.5(c)(1), the City Council has determined that, after considering the record as a whole, there is no evidence that the proposed project will have the potential for any adverse effect on wildlife resources or the ecological habitat upon which wildlife resources depend. The proposed project exists in an urban environment characterized by paved concrete, roadways, surrounding buildings and human activity. Therefore, pursuant to Fish and Game Code § 711.4(c)(2)(A) and Title XIV, CCR § 753.5(a)(3), the payment of Fish and Game Department filing fees is not required in conjunction with this project. Section 4. The City of Santa Ana hereby finds and determines each of the following: A. The public interest and necessity require the proposed project. B. The proposed project is planned or located in the manner that will be most compatible with the greatest public good and least private injury. C. The property located at 2209 S. Bristol Street (APN 015-194-25), as described in Exhibit A and graphically depicted in Exhibit B, is necessary for the proposed project. D. The offer required by Section 7267.2 of the California Government Code was made. Section 5. The City hereby finds, determines and declares that the public interest, convenience and necessity require the acquisition by the City of the property described in Section 4 above, including any and all leaseholds and related improvements, for the purposes of Phase 4 of the Bristol Street Widening Project ("Project'). The location of the Project is between Warner Avenue and St. Andrew Place for the widening of Bristol Street. Included in the project will be street pave -out, and the installation of concrete curbs, gutters, and sidewalks in a manner which will be most compatible to the greatest public good and the least private injury. Section 6. The taking of the interest in the property described in Section 4 above is necessary for the public right of way and is authorized by Section 19 of Article I of the California Constitution; Section 200 of the Santa Ana Charter; Santa Ana Municipal Code section 41-781; California Code of Civil Procedure sections 1240.010, 1240.110; California Government Code sections 37350.5 and 40404; California Streets and Highways Code sections 5101, 5101.5, 5102; and other applicable law. Resolution No. 2017 -XXX Page 2 of 6 75J-57 6/20/17 Section 7. The City hereby declares that it is the intention of the City of Santa Ana to acquire in its name, in accordance with the provisions of the laws of the State of California with reference to condemnation procedures, all interests in and to the property described in Section 4 above. Section 8. If any of the property described in Section 4 above has been appropriated for some public use, the public use to which it is to be applied and taken under this proceeding is a more necessary and paramount public use. Section 9. The property described in Section 4 above is located within the City of Santa Ana, County of Orange, State of California, and is more particularly described in Section 4 hereof. Section 10. The City of Santa Ana is authorized to acquire by eminent domain as provided in the California Code of Civil Procedure. Section 11. The City Attorney is hereby authorized and directed to prepare, institute and prosecute in the name of the City such proceedings, in the proper court having jurisdiction thereof, as may be necessary for the acquisition of the interests in the property described in Section 4 above. The City Attorney is also authorized and directed to obtain a necessary order of immediate possession and occupancy of such property, at the discretion of the City Attorney. Section 12. This Resolution shall take effect immediately upon its adoption by the City Council, and the Clerk of the Council shall attest to and certify the vote adopting this Resolution. ADOPTED this day of 2017. APPROVED AS TO FORM: Sonia A. Carvalho, City Attorney By: Wnn, Fes, J00 M. Funk Assistant City Attorney Miguel A. Pulido Mayor 75J-58 Resolution No. 2017 -XXX Page 3 of 6 AYES: NOES: ABSTAIN: NOT PRESENT: Councilmembers: Councilmembers: Councilmembers: Councilmembers: CERTIFICATE OF ATTESTATION AND ORIGINALITY I, MARIA D. HUIZAR, Clerk of the Resolution No. 2017 -XXX to be the City of Santa Ana on Date: Resolution No. 2017 -XXX Page 4 of 6 Council, do hereby attest to and certify the attached original resolution adopted by the City Council of the Clerk of the Council City of Santa Ana 75J-59 ( EXHIBIT A LEGAL DESCRIPTION Real property in the City of Santa Ana, County of Orange, State of California, desaiped as follows: LOT 192 OF TRACT NO. 1192, IN'THE CITY OF SANTA ANA, COUNTY OF ORANGE, STATE OF CALIFORNIA, AS PER MAP RECORDED IN SOOK 39, PAGES 16 AND 17, MISCELLANEOUS MAPS, IN THE OFFICE OF THE COUNTY RECORDER OF SAID COUNTY. APN: 015-194-25 75J-60 6/20/17 Resolution No. 2017 -XXX Page 5 of 6 EXHIBIT B j In Resolution No. 2017 -XXX Page 6 of 6 75J-61 75J-62 KOA Oki kq *1970 0 1 L - 75J -63 06/15/2017 THU 10:21 FAX Clerk of the Council City of Santa Ana, City Hall 20 Civic Center Plaza, M-30 Santa Ana, CA 92702 Facsimile: 714-647-6956 4001/001 PETERSON LAW GROUP 700 J[JN 15 a PROFESSIONAL CORPORATION i� I0 j 9 SUITE HURB IsITY OF SANM 19800 MACARTHUR BOULEVARD E IRVINE, CALIFORNIA 92612 CLERK OF f'0p1,til:�1j_ TELEPHONE (949) 955.0127 FACSIMILE (949) 955-9007 June 15, 2017 Via Personal Delivery and Facsimile Re: Bearing on Resolution of Necessity — R S Properties, LLC Bristol Street Widening Project APN 015-194-25 2209 S. Bristol Street, Santa Ana, CA ("Subject Property") Dear Members of the City Council: This office represents R S Properties, LLC, owner of the Subject Property. Request is hereby made that this letter be made part of the record, and that we be given the opportunity to be heard at the hearing on the Resolution of Necessity. R S Properties, LLC does not challenge the Resolution of Necessity for the Subject Property. However, the prelitigation offer pursuant to section 7267.2 of the California Government Code is inadequate and does not rise to the fair market value standard. The offer reflects a depression in the surrounding area caused by the project, and thus the offer is project influenced. We look forward to working with the City in reaching a fair and just resolution of the acquisition of the Subject Property that complies with the fair market value standard, CDP: cl Very truly yos, 6 Christopher D. Peterson 75J-64