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personally known to me <br /> )t,l~llavtll:l~Oo be the persan(~ whose name(~ i~ subscribed to the <br /> within btstrument and acknowledged to me that h~ executed <br /> II~ siuae bt hi~ ~ahorized cl~cit~, ~td tl~l by h~ <br /> signalare~ on lite ia*'lrument lite perso,(~, or tile entity ttl~On beha~[ <br /> of which tte perwm~ acted, executed lite ittMrttmettl. ' , <br /> <br /> W[INESS my hand atul qfficial seal ~~ ~ ~~.~ <br /> This area fi~r Official Notarial Seal <br /> <br /> OPTIONAL, <br /> <br /> Though lbo dala below is not required by law, ii may prove valuable lo persons relying on lbo documenl and could <br /> prevenl Iraudulenl reattachment el Ibis form. <br /> <br /> CAPACITY CLAIMED BY SIGNER DESCRIPTION OF A'I-rACHED DOCUMENT <br /> <br /> [] INDIVIDUAL <br /> [] CORPORATE OFFICER <br /> TITLE(Si TITLE OF TYPE OF DOCUMENT <br /> <br /> [] PARTNER(S) [] LIMITED <br /> [] GENERAL <br /> [] ATtORNEY-IN-FACT NUMBER OF PAGES <br /> [] TRUSTEE(S) <br /> [] GUARDiAN/CONSERVATOR <br /> [] OTRER: <br /> DATE OF DOCUMENT <br /> <br /> SIGNER IS REPRESENTING: <br /> <br /> American Contractors <br /> Indemuity Company <br /> SIGNER(S) OTHER THAN NAMED ABOVE <br />~[~-ta3s m~v. s/m~ ALL"PURPOSE ACKNOWLEDGEMENT <br /> <br /> <br />