IFB CSI-2608, Reverse Auction for 2 Used Police Interceptors.pdf

City University of New York IFB for Sale of Two (2) Used Ford Police Interceptors Exhibit A: Bid Form

INVITATION FOR BIDS

Sale of Two (2) Used Ford Police Interceptors

The City University of New York (“CUNY”) is requesting sealed bids in response to this Invitation for Bids public solicitation (“IFB”) for the sale of two (2) used vehicles: 2013 Ford Police pursuit vehicle and 2016 Ford SUV Police Interceptor, which are described in greater detail under Appendix 1 (the “Equipment”). Please note that defined terms may be used before being defined.

1. Acceptance of Terms and Conditions. By submitting a bid in response to this IFB (a “Bid Submission”), the bidder (“Bidder”) agrees that they have read, fully understand, and accept all terms and conditions of the IFB.

2. Withdrawal of Equipment. CUNY reserves the right to withdraw any or all Equipment from this IFB prior to sale. Neither the Bidder offering the highest Bid Price and selected for award (if any, the “Buyer”) nor any Bidders not selected for award shall have any recourse against CUNY or the State of New York or any of its employees or agents.

3. Condition and Location of Equipment.

a. ALL EQUIPMENT IS OFFERED FOR SALE “AS IS” AND “WHERE IS” AND

“WITH ALL FAULTS”. AND EACH VEHICLE WILL BE SOLD AS ONE

COMPLETE LOT. CUNY MAKES NO WARRANTY, GUARANTY OR

REPRESENTATION OF ANY KIND, EXPRESS OR IMPLIED, AS TO (1) THE

CONDITION, QUANTITY, KIND, CHARACTER, OR DESCRIPTION OF ANY

OR ALL OF THE EQUIPMENT, (2) THE COMPLIANCE OF THE EQUIPMENT

WITH THE REQUIREMENTS OF ANY SPECIFICATIONS, LAWS OR

REGULATIONS, OR (3) THE EQUIPMENT’S MERCHANTABILITY OR

FITNESS FOR ANY USE OR PURPOSE.

b. CUNY DISCLAIMS ALL WARRANTIES AND REPRESENTATIONS, WHETHER EXPRESS, IMPLIED, OR STATUTORY, INCLUDING WITHOUT

LIMITATION, ANY IMPLIED WARRANTIES OF MERCHANTABILITY OR

FITNESS FOR A PARTICULAR PURPOSE. CUNY ALSO DISCLAIMS ANY

IMPLIED WARRANTY ARISING OUT OF TRADE USAGE OR OUT OF

COURSE OF DEALING OR COURSE OF PERFORMANCE. CUNY ALSO

DISCLAIMS ANY WARRANTY OR OTHER OBLIGATION ON ACCOUNT

OF ANY CLAIM OF INFRINGEMENT OR MISAPPROPRIATION OF

PATENTS, COPYRIGHTS, OR OTHER INTELLECTUAL PROPERTY

RIGHTS IN CONNECTION WITH EQUIPMENT.

c. Without limiting the foregoing, CUNY makes no guaranty or warranty that the

Equipment is free of viruses, spyware, malware, trojan horses, and the like, and Buyer shall bear the sole risk of the presence of, and be responsible for taking all precautions against, the foregoing. CUNY will not make any payment for damage profit or any other losses, or any damages whatsoever, including, without limitation, special, direct, indirect, punitive or consequential damages.

4. Costs. CUNY does not offer and will not provide compensation for packaging, packing, preparing or shipping costs, travel expenses or effort, or any other costs or expenses incurred by any Bidder or the Buyer in relation to this IFB.

5. Inspection. Equipment offered for sale is used and may contain defects, and Buyer bears the risk of the existence of all such defects. It is each Bidder’s sole responsibility to fully inspect the Equipment before bidding (submitting a Bid Submission) and Bidders are invited and strongly encouraged to do so. Bidders may inspect the Equipment on the following date and time: June 24, 2026 at 11:00 AM at the College of Staten Island, 2800 Victory Blvd, Staten Island, NY, 10314. Interested Buyers are required to notify the Designated Contact by June 23, 2026 on 4:00 PM of their intent to attend the inspection.

Failure to inspect the Equipment does not constitute grounds for the withdrawal of a Bid Submission after opening.

6. Questions. Any questions regarding this IFB must be made in writing by letter or email to the attention of Mark Zilberg, Finance Procurement Agent (the “Designated Contact”) located at 2800 Victory Blvd, Room 3A-102, Staten Island, NY 10314, Mark.Zilberg@csi.cuny.edu. All questions must be received by the Designated Contact no later than 4 PM on June 29, 2026 (the “Questions Deadline”). CUNY may in its discretion include any questions received by the Questions Deadline and associated answers, as well as any amendments or clarifications to this IFB, in written addenda to this IFB, and may distribute such Addenda by mail or email to each party recorded as having been sent a copy of the IFB. Bidders may not contact any person at CUNY in relation to this IFB other than Designated Contact.

7. How to Submit a Bid in Response to This IFB.

a. Bidder’s submission of a Bid Submission in response to this IFB shall constitute an offer to: (1) buy the Equipment for the price set forth in the Bid and on the terms and conditions contained in this IFB; (2) remove the Equipment by the date and time specified in this IFB; and, (3) perform all other terms and conditions offset forth in the IFB. Bid Submissions shall be firm, and may not be withdrawn by Bidders, for ninety

(90) days after submission. CUNY’s notice of award to the Buyer shall constitute an acceptance of such offer, and shall, together with the Buyer’s Bid Submission and the terms of this IFB, constitute a binding contract for the purchase of Equipment and the performance of all other terms and conditions set forth in this IFB.

b. All Bid Submissions must be made on the official Bid Form provided as Exhibit A of this IFB and must be submitted in a sealed envelope on or before July 9, 2026 at 4 PM, to The College of Staten Island, 2800 Victory Blvd, Staten Island, NY 10314, ATTN: Mark Zilberg, Finance Procurement Agent. Bid Submissions will not be accepted if not received at the Bid Submission Due Location by the Bid Submission Due Date and Time. Bid Submissions must be completed in ink and signed in ink. Only mailto:Mark.Zilberg@csi.cuny.edu original signed Bid Submissions will be accepted. No faxes, emails, or copies of Bid Submissions will be accepted.

c. n/a

d. Do not attempt to change any terms of the IFB in your Bid Submission or offer alternate terms with your Bid Submission for the transactions contemplated herein. A Bid Submission made on any terms other than those specified in this IFB shall, at the option of CUNY, be declared non-responsive and rejected.

e. All Bid Submissions must be sealed and submitted by hand, mail, or express or overnight delivery.

f. Bid Submissions must be submitted with the Bid Deposit described in section 9 below, and with any applicable tax exemption certificate described in section 13 below.

g. Do not include sales or other taxes in your Bid Price calculation; such taxes, if applicable, will be separately assessed and collected from the Buyer as described below.

h. The Bidder agrees that solely for the purpose of evaluating Bid Submissions offered for the Equipment, its offered Bid price shall be computed as the summation of the Extension Prices of all the items listed in the Bid Form. This summation will be referred to as the Bid Price. In the event of an arithmetic discrepancy between the Unit Price and the Extension Price, the Unit Price will prevail. CUNY may correct any arithmetic errors in its sole and absolute discretion, and such corrected Extension Prices and Bid Price shall be binding on the Bidder.

8. Bid Deposit. Bid Submission must be accompanied by a deposit in the form of a cashier’s check, certified check or money order made payable to “The City University of New York” for ten percent (10%) of the amount of the Bid Price (the “Bid Deposit”). No cash or personal checks will be accepted. The Bid Deposit of the Buyer will be applied as partial payment. The Bid Deposits of Bidders not selected will be returned within ten (10) business days of the completion of award to the Buyer.

9. Award.

a. An award under the IFB, if any, shall be made to the bidder offering the highest Bid

Price) that is determined by CUNY to be both responsive and responsible (as defined under New York State law). In the event a tied Bid Submissions or disputed Bid Submissions, CUNY may in its discretion determine the highest bidder in any manner it deems to be in its best interest, including, without limitation, permitting tied bidders to make best and final offers.

b. CUNY shall notify the Bidder to whom CUNY intends to make an award (an “Initial Notice of Award”). CUNY shall also inform such Bidder of any applicable taxes due, and CUNY’s calculation of such amounts shall be final and binding.

c. CUNY reserves the right, as a condition to final award, or as a condition to the release of the Equipment, to require any Bidder to submit such forms, documents and other materials as CUNY may require, including, without limitation, evidence to CUNY’s satisfaction of the bidder’s responsiveness and/or responsibility (as defined by New York State law). CUNY also reserves the right to request any Bidder as a condition to award to execute and deliver to CUNY a Bill of Sale in the form attached hereto as

Exhibit B and the Form of Release attached hereto as Exhibit C. Such Bidder shall submit such forms, documents and other materials to CUNY within 5 days of request, therefore.

d. Once Bidder has met all conditions to CUNY’s satisfaction, CUNY shall issue such bidder a notice of award a “Notice of Award”). For purposes of this IFB such Notice of Award shall be deemed to be received by the Bidder one day after such Notice of Award is dated.

10. Payment.

a. The Buyer must remit to CUNY within five (5) business days after the Bidder’s receipt of the Notice of Award, an amount equal to the balance of the Buyer’s offered Bid Price (after taking into account the Bid Deposit) and all applicable taxes identified by CUNY (collectively, the “Final Payment”). The Final Payment must be paid in the form of a cashier’s check, certified check or money order, payable to “The City University of New York on behalf of College of Staten Island”.

b. The Final Payment must be delivered to 2800 Victory Boulevard, Staten Island, NY 10314

c. The Final Payment must be received prior to, and will be a condition to, the release of the Equipment by CUNY.

11. No Refunds; Risk of Loss; Transfer of Title. All sales are final. Buyer shall have no right to refunds, exchanges, turndowns, returns, or the like. Risk of loss to the Equipment passes to the Buyer upon CUNY’s transmission of a Notice of Award. Title shall pass to the Buyer upon Buyer’s payment of all amounts due, and removal of the Equipment as required above. A final Bill of Sale in form of Exhibit B shall be issued following receipt of the Final Payment and removal of the Equipment as required herein, and Buyer shall countersign any such Bill of Sale as required by CUNY. CUNY may require the Bill of Sale to be countersigned by the Buyer in advance of the removal of the Equipment and/or in advance of CUNY’s execution of the Bill of Sale.

12. State/Local Sales and/or Use Tax. New York State buyers shall be subject to payment of applicable State and/or local sales and/or use tax. Applicable sales tax must be remitted to CUNY as part of the Final Payment as set forth above. If a bidder intends to claim non-applicability of the New York State and/or New York City Sales Tax, the Bidder must submit the appropriate certificate (resale or exemption) with identification (if any) to CUNY with its Bid Submission. If the certificate is a resale certificate, it must be a simple-purchase certificate. Applicable sales tax will be charged and payable if no exemption certificate is attached to a Bid Submission.

13. Cataloguing and Removal of Equipment; Insurance.

a. Prior to removing any Equipment from CUNY, Buyer shall catalogue all Equipment by recording of each piece of Equipment and submit a copy of such catalogue to CUNY. The Buyer will make all arrangements and perform all work necessary to remove the Equipment at its sole cost and expense, including, without limitation packing, loading and transportation of the Equipment. The Buyer must remove all

Equipment from the location identified in Section 5 within fifteen days following receipt of the Final Notice of Award, time being of the essence.

b. The Buyer must maintain commercial general liability insurance covering personal injury and property damage with at least $1,000,000 in coverage and naming CUNY, the Dormitory Authority of the State of New York, The City of New York, and the State of New York as additional insured. The Buyer must provide CUNY an ACORD certificate evidencing such insurance prior to its removal of the Equipment. Buyer will provide copies of such insurance policies and all endorsements upon CUNY’s request.

c. Upon receipt of the Final Notice of Award the Buyer must contact the Primary Contact or any alternate contact listed in the Final Notice of Award and arrange for a pick-up time. The Buyer must bring to the pick-up location, as a condition to the release of the Equipment, (1) the Final Notice of Award, (2) personal identification (such as a Driver's License) and, (3) if not previously provided to CUNY, the Final Payment and the certificate of insurance as required by subsection 14(b) above. If a representative of the Buyer is picking up any Equipment, that representative must bring all items required by the previous sentence, and a note from the designated Buyer specifically naming the authorized representative, along with personal identification. In addition, the selected Bidder must send an e-mail from the e-mail address listed in its Bid Form stating the name of the person authorized to pick up the item. Without limiting any other provision of this IFB (including, without limitation, provisions relating to the remedies available to CUNY following a Buyer’s default), Buyer’s failure to timely remove the Equipment shall be a default, and any Equipment not so removed shall be deemed abandoned by Buyer and shall remain the property of CUNY, and CUNY shall retain the Bid Deposit of such Bidder.

14. Damage to Person and Property and Indemnification.

a. The Buyer is responsible for all damage to CUNY property and facilities caused during the packing, loading, and/or removal of Equipment, and will reimburse CUNY for the costs of repairs or replacement of damaged property and facilities within five (5) days of CUNY’s request, time being of the essence. Without limiting CUNY’s other rights or remedies under this IFB, if CUNY property or facilities are so damaged Buyer will not be allowed to complete removal of the Equipment until CUNY’s has received such reimbursement.

b. The Buyer shall be solely responsible for all injuries to persons, including death, or damage to property sustained during its operations contemplated under this IFB (including, including without limitation, damage to CUNY property during the removal of the Equipment) resulting from any negligence, fault or default of the purchaser or of its employees, authorized agents, servants, independent contractors or subcontractors retained by the Buyer. The Buyer agrees to indemnify, defend and hold CUNY, the Dormitory Authority of the State of New York, the State of New York and the City of New York and each of their agents and employees (collectively, the “Indemnified Parties”) harmless from any liability upon any and all claims, judgments, or liabilities relating to injuries to persons (including death) and damage to property on account of negligence, fault or default of the Buyer, its employees, authorized agents, servants, independent contractors and subcontractors.

c. In addition, the Buyer shall indemnify, defend and hold harmless the Indemnified Parties from any and all claims, judgments or liabilities relating to (1) any negligence or any fault or default of the Buyer, its employees, authorized agents, servants, independent contractors and subcontractors, (2) the breach of the Buyer's obligations contemplated under this IFB and/or (3) the packing, removal, handling, shipping, use, possession, transfer, sale, donation or other disposal of the Equipment.

d. The Equipment may contain flammable items, radioactive materials, explosives, hazardous or toxic substances, material or waste or related materials, including any materials defined as or included in the definition of “hazardous substances”, “hazardous wastes”, “infectious wastes”, “hazardous materials” or “toxic substances” now or subsequently regulated under any federal, state, or local laws, regulations, or ordinances (“Hazardous Material”). The Buyer will defend, indemnify, and hold the Indemnified Parties harmless against any claims resulting from or relating to such Hazardous Material and arising after the Buyer has taken possession of the Equipment.

e. The obligations contained in this Section 15 shall survive the termination or expiration of this IFB or any contract that is created as a result of this IFB and shall survive the conclusion of the transactions contemplated herein.

15. Personal and Property Risk. Persons attending the exhibition, sale or removal of the

Equipment assume all risks of injury, damage or loss to person and/or property and shall be deemed to release the Indemnified Parties from all liability related to such risks.

16. Default. Failure to comply with any of the terms and conditions described in this IFB shall be cause for CUNY to declare the Buyer in default of its obligations hereunder and to exercise any or all of the following remedies: withdraw any Initial Notice of Award or Final Notice of Award; retain the Buyer’s Bid Deposit and Final Payment as liquidated damages; issue another solicitation for the Equipment; sell the Equipment to the next highest bidder under this IFB; require the Buyer to immediately return all Equipment to CUNY; and/or to exercise any other remedy available under law or contract. Following a default Buyer shall forfeit any rights to the Equipment unless such default is waived by CUNY in writing, and Buyer shall return all Equipment to CUNY within 5 days of any request by CUNY therefor.

17. Use of Equipment. Buyer shall responsibly use the Equipment including its disposition in conformance with applicable law, rules and regulations. If the Buyer disposes of any Equipment or components in a manner that is subject to Federal, State or local regulation, Buyer is solely responsible for compliance with such regulation.

18. Release and Limitation of Liability

a. Upon removal of the Equipment by Buyer as contemplated above, Buyer shall be automatically deemed to have fully released each of the Indemnified Parties from any and all claims, demands and causes of action whatsoever which the Buyer has or may have against any of the Indemnified Parties in connection with this IFB or the Equipment, without the need to execute any separate document or instrument. If CUNY requests that Buyer execute a separate written release, Buyer shall execute and deliver to CUNY such a release in the form and substance required by CUNY and within five (5) days of CUNY’s request.

b. TO THE MAXIMUM EXTENT ALLOWED BY LAW, UNDER NO

CIRCUMSTANCES WILL CUNY BE LIABLE FOR ANY DAMAGES OF ANY

KIND, WHETHER DIRECT, INDIRECT, SPECIAL, INCIDENTAL,

CONSEQUENTIAL OR PUNITIVE, EVEN IF THEY WERE FORESEEABLE

AND/OR EVEN IF THE CONTRACTOR HAS INFORMED CUNY OR ANY OF

THE COLLEGES OF THEIR POTENTIAL, ARISING IN ANY WAY OUT OF THE

EQUIPMENT OR THE CONTRACT.

19. Contract Formation; Survival of Terms. A bidder’s Bid is an offer to contract on the terms and conditions contained in this IFB. CUNY’s Notice of Final Award shall create a binding contract between CUNY and the bidder, consisting of the terms of the IFB, the bidder’s bid, and the Final Notice of Award (the “Contract”). The requirements of the Buyer under the Contract shall survive any termination or expiration of the Contract and shall remain in full force and effect thereafter, including, without limitation, following the consummation of the transactions described herein.

20. Miscellaneous. No oral statement or representation changing or supplementing this IFB or any condition thereof is valid. No assignment, transfer, conveyance or other disposition of this IFB or any interest therein shall be valid without the prior written consent of CUNY.

If any provision of this IFB is ruled invalid by any court of competent jurisdiction, the invalidity of such provision shall not affect any of the remaining provisions hereof.

Headings used herein are for informational purposes only and shall not be interpreted as limiting any of the provisions of this IFB. CUNY reserves the right to: (a) waive IFB technicalities and/or Bid irregularities and/or omissions; (b) reject any or all bids when deemed in the best interest of CUNY and to withdraw from sale any item of the Equipment listed; (c) terminate or cancel this IFB on written notice to all bidders; (d) seek clarifications, request Bid revisions, and/or request any information deemed necessary for proper evaluation of Bids from any or all bidders deemed to be eligible for award;

(e) change the deadlines in this IFB; (f) require the Buyer to execute a separate written agreement in form and substance acceptable to CUNY for the transactions contemplated herein to replace or supplement this IFB; (g) correct mathematical errors contained in a Bid (and any corrected Total Bid shall be final and binding on the bidder); and/or (h) otherwise amend the terms of this IFB.

[Remainder of Page Intentionally Left Blank]

Appendix 1: Equipment Specifications

Provide Product Information Here:

1. 2013, Ford Sedan Police Pursuit Vehicle, VIN# 1FAHP2MK7EG182967

2. 2016, Ford SUV Police Interceptor, VIN# 1FM5K8AR7GGD33014

Exhibit A

Bid Submission Form

Capitalized terms that are not defined but used herein shall have the meaning set forth in the Invitation for Bids to which this Bid Form is attached (the “IFB”). By submitting this Bid Form, the bidder indicated below (“Bidder”) hereby offers to purchase the following Equipment for the Total Bid price entered below and offers to perform all requirements of the IFB subject in all respects to the terms and conditions of the IFB. Bidder acknowledges and agrees that, as more fully stated in the IFB, all items below are being sold by CUNY in an “AS IS” and “WHERE IS” condition without any representations or warranties whatsoever by CUNY. By submitting this Bid Form Bidder also accepts and agrees to all terms and conditions of the IFB and certifies that all information and documents included with its Bid are true and accurate.

Instructions: Do not include sales or other tax in your Bid Price. The Buyer shall pay all applicable taxes in accordance with the terms of the IFB. In Column B fill in the respective Unit Price for each item. Calculate the respective Extension Price for each item by multiplying amounts in Columns A and B and entering the product into Column C. Enter the sum of all Extension Prices for each item into Line D and Line E; this is your Total Bid. Write your Total Bid in words in Line F. Have an authorized individual sign this Bid Form on behalf of the Bidder and enter all requested information that was indicated below. Check the box below indicating where you will Sanitize all data from the Equipment. Enter Bidder’s contact information and sign the Bid Form were indicated below.

Item

(Column A)

Count

(Column B)

Unit Price

(Column C)

Extension Price

(A) x (B)

2013 Ford Police pursuit 1

2016 Ford SUV Police Interceptor 1

(Extension Price) Bid Price: $____________

[Bid Submission Form continues on next page]

Bid Price being offered to acquire the equipment listed in Exhibit A $ *

Price in words:

*Determination of whether a Bidder is the “highest Bidder” will be based on this amount.

Bidder: Sign Below

Bidder hereby offers to purchase the Equipment for the Bid Price and to perform all other requirements set forth in the IFB, including, without limitation, all Data Sanitization.

BIDDER: _____________________________________________________

(Print or type corporation, partnership, or individual name)

BY: _________________________________________________________

(signature of authorized representative)

NAME: _______________________________________________________

(print or type name of authorized representative)

TITLE: _______________________________________________________

(print or type title of authorized representative)

ADDRESS: ____________________________________________________

PHONE: ______________________________________________________

EMAIL: ______________________________________________________

DATE: ________________________________________________________________

Exhibit C: Form of Release

Exhibit B

Form of Bill of Sale

BILL OF SALE

THIS BILL OF SALE (the “Bill of Sale”) is made and entered into as of ___________, 20__ (the “Effective Date”), by The City University of New York, whose address is ______________________ (the “Transferor”), to ___________, a ___________, whose address is ______________________ (the “Transferee”).

TRANSFEROR, in consideration of _______ Dollars, and other good and valuable consideration, the receipt and sufficiency of which are acknowledged, bargains, grants, sells, conveys, assigns, transfers, and delivers to Transferee all personal property listed in Schedule 1 to Bill of Sale attached hereto (the “Personal Property”).

TO HAVE AND TO HOLD the Personal Property unto Transferee and Transferee’s successors and assigns forever.

THIS BILL OF SALE is made subject to the terms and conditions of that certain Invitation for Bids for the sale of the Personal Property issued by Transferor on ____________, and is made without representation, warranty, guarantee, or other assurance or covenant of any kind, and without recourse with respect to Transferor or with respect to any of the partners, officers, agents, employees, representatives or other constituent entities of Transferor.

This Bill of Sale shall bind and benefit Transferor, Transferee, and their heirs, successors and assigns.

IN WITNESS WHEREOF Transferor has executed this Bill of Sale as of the Effective Date.

THE CITY UNIVERSITY OF NEW YORK

By: ___________ Name:

Title:

Transferee assumes, as of the Effective Date and continuing from and after the Effective Date, all of Transferor’s obligations under or with respect to the Personal Property, expressly for the benefit of Transferor. Transferee agrees to comply with, observe and perform any and all the duties relating to the Personal Property that are required to be performed or observed on or from and after the Effective Date.

By:

Name:

Title:

Attachments: Schedule 1 to Bill of Sale - Personal Property Description

SCHEDULE1

TO BILL OF SALE

Personal Property

2013 Ford Police pursuit vehicle and 2016 Ford SUV Police Interceptor as described in Appendix 1

STATE OF

COUNTY OF

) ss: RELEASE

TO ALL TO WHOM THESE PRESENTS SHALL COME OR MAY CONCERN

with offices located at , (“Releasor”) for and in consideration of the receipt of the items listed on Schedule 1 listed hereto (the “Personal Property”) from The City University of New York (“CUNY”), , in relation to that certain Invitation for Bids for the sale of the Personal Property issued by CUNY on or about (the “IFB”) and other good and valuable consideration received, the sufficiency of which Releasor represents is adequate, releases, remises, and forever discharges CUNY, the Dormitory Authority of the State of New York, the City of New York, the State of New York, CUNY’s trustees, officers, employees, and assigns, of and from all manner of action and actions, accounts, reckonings, bonds, bills, specialties, covenants, contracts, controversies, agreements, promises, variances, trespasses, damages, judgments, extents, executions, claims and demands whatsoever, at law, admiralty or in equity, which, against CUNY, the Dormitory Authority of the State of New York, the City of New York, or the State of New York, or any combination of them, that the Releasor, its heirs, executors, administrators, successors and assigns ever had, now have or hereinafter can, shall or may have for, upon, or by reason of any matter, cause or thing whatsoever in relation to the Personal Property or the IFB. This Release may not be changed orally.

IN WITNESS WHEREOF, Releasor causes this instrument to be duly executed, and these presents to be signed by the named individual and, if applicable, the duly authorized officer of the corporation, effective as of the date set forth below.

Date:

(Name of Releasor)

By:

(Signature)

Name:

(Print name) Title:

V05.08 (Print title)

ACKNOWLEDGMENT OF

State of …………………. ) )ss.:

County of ............................... )

On the ............ day of ……………….......... in the year ……….... before me, the undersigned, personally appeared …………………………………………………..

..............................................................................................., personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument.

Notary Public