March 9, 1993 Page Two RPDD property frontage boundary line along the state highway, and such construction interferes with or may interfere w

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1 C. RPDD OS-60(' (v-89) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF TRANSPORTATION Office of Chief Counsel DATE : March 9, 1993 SUBJECT : TO : FROM : Highway Occupancy Permits - New Forms 1. Form M-950K, Highway Occupancy Permit Obligation Bond (11-92) 2. Form M-950R, Agreement of Release (1-93) 3. Draft Form M-950D1, Deed, Fee Simple (2-93) 4. Form M-950D2, Deed of Easement (2-93) ALL ASSISTANT COUNSEL - REGIONAL OFFICES ALL ASSISTANT COUNSEL - REAL PROPERTY DIVISION ALL DISTRICT ENGINEERS ALL DISTRICT PERMIT ENGINEERS ALL DISTRICT RIGHT OF WAY ADMINISTRATORS William J. Cressler Assistant Chief Counsel Real Property Division I am herewith providing the referenced new forms for use in your highway occupancy permit program administered under the provisions of Department regulations relating to occupancy of state highways by driveways and local roads, Title 67 Pa. Code, Chapter Form M-950K, Highway Occupancy Permit Obligation Bond. As a pre-condition to issuance of their H.O.P., the Department may require individual Chapter 441 permittees to submit a Highway Occupancy Permit Obligation Bond in situations where District Permit Managers determine that posting a bond or other security is appropriate. See RPDD Driveway Permits - Bonds and Other Security, copy attached. 2. Form M-950R, Agreement of Release. This release should be utilized by District Permit Managers in all situations where it has been determined that construction to be permitted by the Department pursuant to a highway occupancy permit will adversely affect or change the operating characteristics of an existing permitted or unpermitted access to the state highway. Once obtained, the release should be recorded, and maintained as a permanent record with the permit. Specifically, the form should be utilized in the following situations : (a) 67 Pa. Code 441.8(d) and (i), relating to property line clearance and auxiliary lanes. The release should be used where a portion of a planned access, including auxiliary lanes, turning lanes, a curb radius or other structure, is to be located outside of the permittee's Making It Happen

2 March 9, 1993 Page Two RPDD property frontage boundary line along the state highway, and such construction interferes with or may interfere with existing or future access available to an abutting property.owner along the state highway. The District Permit Manager should insure that the permittee, as a condition to issuance of the permit, obtains the, release, executed by the affected property owner. (b) 67 Pa. Code 441.8(m), relating to median installation and removal. In the event the Department requires a permittee to either place or remove a median strip within the state highway which will adversely affect, modify or change the operational characteristics and access patterns of an existing permitted or unpermitted access serving an abutting or adjacent property owner, the District PermitManager should insure that the permittee obtains an agreement of release from the affected property owner as a condition to issuance of the permit. (c) 67 Pa. Code 441.8(n), relating to shoulder upgrades. Whenever the Department requires an existing shoulder to be upgraded in conjunction with construction under a highway occupancy permit, and the required construction will adversely affect or change the operational characteristics of an abutting property owner's existing permitted or unpermitted driveway, the District Permit Manager should insure that the permittee provides the Department with an agreement of release executed by the affected property owner as a condition to issuance of the permit. In the event that a highway occupancy permit applicant is unable to obtain the requested agreement of release in situations where the access pattern or operational characteristics of an existing permitted or unpermitted driveway on property abutting or adjacent to the applicant will be adversely affected or changed, the District Permit Engineer should consult with the Permit Program Attorney, Office of Chief Counsel, to determine what action is appropriate. 3. Form M-950D1, Deed, Fee Simple. This Deed may be used in conjunction with and as a condition to issuance of a highway occupancy permit wherever the District Permit Manager determines that additional right of way will be required for the construction of the planned access in accordance with Department standards. For example,

3 March 9, 1993 Page Three RPDD where the width of the highway right of way is insufficient to permit construction of a needed auxiliary lane, the permittee must provide any necessary additional right of way to the Department. 67 Pa. Code 441.8(j)(3). If the permittee has negotiated to purchase the necessary right of way from another person, the property should first be conveyed to the permittee and then to the Department using this deed form. The deed utilizes a "plot plan" referenced as an exhibit. The permittee is required to provide a title report or bring down, updated to within 15 days of the date the permit is to be issued. The executed deed and the title information must be reviewed and accepted by the Right of Way Administrator prior to issuance of the permit. Once the executed deed is obtained, it must be recorded. Individual districts must develop procedures to insure acquisition of the new right of way is properly documented by the Department for future reference and use by the District. 4. Form M-950D2, Deed of Easement. This deed form may be used where the attorney for the applicant is unwilling to give the Department fee simple title. The same procedures as set forth in paragraph 3 above should be used. Should you have any questions regarding the implementation and use of these new forms, please contact the Permit Program Attorney, Thomas R. Haist, Assistant Counsel, directly at /WJC/TRH :mls (Panet ) cc : John L. Heaton, Chief Counsel Robert H. Raymond, Jr., Deputy Chief Counsel Michael M. Ryan, P.E., Director, Maintenance and Operations, Rm. 1004, T. & S. Bldg. Walter L. Knerr, Permits Section, Maintenance and Operations, Rm. 1014, T. & S. Bldg. Walter E. Bortree, P.E., Director, Operations Review Group, Rm. 105, T. & S. Bldg. Harry G. Zimmerman, Internal Audits, Rm. 716, T. & S. Bldg. Thomas R. Haist, Assistant Counsel in Charge, Permit Section

4 OS-600 i3-89) RPDD COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF TRANSPORTATION DATE SUBJECT : TO : Office of Chief Counsel November 1, 1991 Driveway Permits - Bonds and Other Security ALL DISTRICT ENGINEERS ALL ENGINEERING DISTRICT PERMIT MANAGERS FROM : William J. Cressler Assistant Chief Counsel Real Property Division A question has recently arisen as to the propriety of conditioning issuance of highway occupancy permits for driveways issued under 67 Pa. Code, Chapter 441 upon the posting of bonds or other security, and obtaining liability insurance. As the highway occupancy permit program is now designed, there are several security documents available for use by District Permit Managers in connection with highway occupancy permits issued under 67 Pa. Code Chapter 459, relating to highway occupancy by utilities. (Form M-945K, Highway Restoration and Maintenance Bond, Form M-945L, Irrevocable Letter of Credit, etc.) No standard security document format is available for the permit managers to use under the Chapter 441 program, which relates to occupancy of highways by driveways and local roads. As currently promulgated, the Department's Chapter 441 regulations do not mention that issuance of such permits may be conditioned on receipt of appropriate security. Draft regulations currently being reviewed by the office of Chief Counsel do, however, contain provisions relating to security for driveway permits. Insurance is already provided for in Department regulations at 67 Pa. Code 441.6(14). The lack of existing regulations does not prohibit conditioning issuance of permits on obtaining appropriate security, including bonds and insurance. The State Highway Law itself grants the Department authorization to condition issuance of driveway and local road permits on the posting of appropriate security : "Permits may be conditioned upon posting of bonds or other security and liability insurance. Any bonds or other security relating to highway restoration posted in connection with surface opening Making It Happen

5 RPDD Driveway Permits - Bonds and Other Security November 1, 1991 Page Two permits shall be based on highway restoration costs..." 36 P.S (b). As set forth, security for surface openings permitted under Chapter 459 are required by law to be based upon highway restoration costs, and may not exceed a period of two years from the Department's acknowledged completion of work. However, this requirement is not imposed by the law for driveway related construction required under Chapter 441. Accordingly, it is the opinion of the Office of Chief Counsel that District Permit Managers may require security in an appropriate amount and form prior to issuance of any driveway permit. In a case involving substantial amounts of construction, security amounts may be based on the Department's anticipated cost to complete or modify unfinished construction, as well as anticipated inspection costs and any possible attorney's fees. Of course, it goes without saying that when security is required by the Department, the amount should never be lower than the Department's anticipated cost to restore the highway to its pre-permit condition. The following are acceptable forms of security : 1. An irrevocable letter of credit, in a form acceptable to the Department. This is often considered a simple and convenient form of security document that provides the Department with especially good protection. The issuing bank will simply pay the Department for any expenses actually incurred in connection with the permit upon demand in accordance with the letter in question. The standard form M-945L may be used ; modifications must be approved by the Office of Chief Counsel, Permit Program Attorney. 2. An individual bond, executed by the permittee and its insurance company naming the Commonwealth as an obligee. While this is an acceptable and standardized form of security, it does require that the Department make a claim against the permittee's insurance company in order to collect. In the event the obligor fails to pay, a lawsuit

6 RPDD Driveway Permits - Bonds and Other Security November 1, 1991 Page Three must be initiated in order to recover amounts expended by the Department in connection with the permit. Form 945L may be used, but will require modification which must be approved by the Office of Chief Counsel. 3. An escrow account, in a form acceptable to the Department. This form of security would require the permittee to deposit cash or certificates of deposit with a bank to secure its obligation to complete the work, restore the highway, and pay inspection costs as well as attorney's fees. Although it does provide a high level of security to the Department, it is often unacceptable to permittees since it requires them to obligate large amounts of cash, and requires added time to prepare an individualized escrow agreement which must be approved by the office of Chief Counsel, Permit Program Attorney. The Office of Chief Counsel, Permit Program Attorney is available to aid in the review and preparation of any appropriate security documentation at the request of a District Permit Manager. Chief Counsel will consult, if appropriate, with the Central Office Permit Program Administrator. Should there be further questions or concerns regarding this matter, they may be directed to your Permit Program Attorney, Thomas R. Haist, at /WJC/TRH :mls (Panet ) cc : John L. Heaton, Chief Counsel Robert H. Raymond, Jr., Deputy Chief Counsel Michael M. Ryan, P.E., Director, Maintenance and Operations, Rm. 1004, T. & S. Bldg. Walter L. Knerr, Permits Section, Maintenance and Operations, Rm. 1014, T. & S. Bldg. Walter E. Bortree, P.E., Director, Operations Review Group, Rm. 105, T. & S. Bldg. Harry G. Zimmerman, Internal Audits, Rm. 716, T. & S. Bldg. Thomas R. Haist, Assistant Counsel in Charge, Permits Section

7 Draft Form M-950K (11-93) AGREEMENT NO. H.O.P. NO. FEDERAL ID NO. HIGHWAY OCCUPANCY PERMIT OBLIGATION BOND BOND NO. EFFECTIVE DATE KNOW ALL MEN BY THESE PRESENTS, That we (NAME OF PRINCIPAL-PERMITTEE) of as PRINCIPAL, and of (MAILING ADDRESS OF PRINCIPAL-PERMITTEE) (NAME OF SURETY) (MAILING ADDRESS OF SURETY) are held and firmly bound unto the Commonwealth of Pennsylvania, Department of Transportation, Harrisburg, PA 17120, as OBLIGEE, in the full and just sum of Dollars (S ). good and lawful money of the United States of America, to be paid to the said Commonwealth of Pennsylvania, or its assigns, to which payment will and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the PRINCIPAL has applied to the Department of Transportation for a Highway occupancy permit under the provisions of Title 67 Chapter of the Pennsylvania Code, which requires a bond to secure performance of PRINCIPALS design and construction and indemnification obligations under the permit, the Department costs for inspecting the work and the PRINCIPAL'S obligation to maintain and restore damage to the highway pursuant to 36 P.S of the State Highway Law and 67 Pa. Code Chapter 441, because a substantial amount of work will be performed for or by the PRINCIPAL under such permits. NOW, THEREFORE, the condition of this obligation is such that, if the above bounden PRINCIPAL shall in all respects comply with and faithfully perform the terms and conditions of the permit and all applicable provisions of 67 Pa. Code Chapter 441, according to Department specifications and standards, and shall save and hold harmless the OBLIGEE from any damages or losses from any cause arising from the work to be performed under such permits, and shall further faithfully comply with the terms of each agreement entered into between the Commonwealth, Department of Transportation and the PRINCIPAL in connection with the permit, if any, then this obligation shall be void and of no effect, but otherwise is to be and remain in full force and effect. PROVIDED, that any change which may be made by agreement between the Commonwealth of Pennsylvania, Department of Transportation, and the PRINCIPAL in the terms, conditions and requirements of the permit or any agreement executed in connection with such permit, or the granting by the OBLIGEE of any extension of time for the performance of work under the permit or any other forbearance on the part of either the OBLIGEE or the PRINCIPAL to the other, shall not in any way release the PRINCIPAL or the SURETY or either of them, their heirs, executors, administrators, successors and assigns from their liability hereunder, notice to the SURETY of any such change, extension or forbearance being hereby waived. PROVIDED, that with respect to the Highway Occupancy Permit, and any supplements thereto, and any agreement between OBLIGEE AND PRINCIPAL entered into in connection therewith, the duration of the obligation under this bond shall be for the period during which work is performed under such permit, supplement or agreement, and for two years after the Department's acknowledgement of completion of all work authorized thereunder. PROVIDED that upon Department's written acknowledgement of completion of the work authorized by the Highway Occupancy Permit, any supplements thereto and any agreement entered into between PRINCIPAL and OBLIGEE, and upon payment in full of all costs, fees and expenses incurred by the OBLIGEE and required to be paid or reimbursed by PRINCIPAL, the amount of this bond may be reduced to the full and just sum of Dollars (S ), to secure PRINCIPAL'S obligation to maintain all driveways and adjacent areas within the highway right of way so as to conform with the permit and to restore damage to the highway, in accordance with 67 Pa. Code PROVIDED, the SURETY may terminate its future liability under the Bond ninety (90) days after furnishing written notice of ouch inte on g o piste terminate, delivered by certified mail, to the epartment a Iti app P

8 District Permit Office and the Central Permit Office, Bureau of Maintenance a : Operations, located in the Transportation and Safety Building, Harrisburg, Pennsylvania This termination shall not affect liability of the SURET' and the PRINCIPAL for any liability, thing, occurrence or violation of or incurred by the PRINCIPAL under the permit, any supplements thereto in any agreement executed in connection therewith, or under this Bond prior to the effective date of such termination, but the liability of the PRINCIPAL and t SURETY for any liability, occurrence, violation or thing incurred by or of ti PRINCIPAL under this Bond, the Permit, any supplements thereto, and any agreement executed in connection therewith prior to effective date of termination shall continue beyond the date of termination until such time as the PRINCIPALS liability is completely discharged and satisfied. PROVIDED, that in case of default of the PRINCIPAL, in any respect, OBLIGEE shall have the right to require SURETY to complete or modify any necessary work, to restore the highway and pay the OBLIGEE for all related costs, or at the OBLIGEE'S option, action on this bond may begin forthwith, at PRINCIPAL and SURETY, jointly and severally, do hereby authorize and empower any attorney of any court of record in Pennsylvania or elsewhere, to appear fc and to enter judgment against them, jointly and severally, for the OBLIGEE'S cost of completion or modification of PRINCIPAL'S design and construction obligations under the PERMIT, including any other costs and fees imposed under the PERMIT, any supplements thereto and any agreement executed in connection therewith, and for proper restoration of the State Highways affected by the permitted work, not to exceed the aforementioned sum, with or without defalcation, with costs of suit, with release of errors, without stay of execution and with ten percent (10%) attorney's fees added for collect_ ion, and waiving inquisition on any real estate and exemption of any property whatsoever, authorizing condemnation of same and immediate issuance of a Writ of Execution, and releasing and waiving relief from any and all appraisement, stay of execution, or exemption laws of any state, now in force or hereinafter to be passed. PROVIDED, FURTHER, that in the absence of default, this Bond shall rema in full force and effect and may not be cancelled by the SURETY without writ permission of the OBLIGEE'S Permit Office. Time limitations set forth in this Bond shall not be deemed to relieve t PRINCIPAL of liability for the performance of any requirement under the permit supplements or any agreement executed in connection therewith, exceeding the time limitations set forth in 36 P.S , 67 Pa. Code Chapter 441, the permit or agreement or any other law, statute or regulation. Date ATTEST: BY 0 Secret" 0 Assistant Secretary PRINCIPAL. PERMITTEE 0 Treasurer 0 Assistant Treaswsr 0 President 0 Vies-President O ' ~ 0 Other w (W-AQ ' ATTEST: BY 0 Secretary O Assistant Secretary PRINCIPAL O Treasurer O Assistant Treasurer O President O vice-president O cow., w 0 Other witnest Ttsr SURETY Pennsytvan&a Resident Agent - When Required APP OvED As TO IFGAIJTV A?C FORM By c cevuer - f P110440k r e G~N-W- r Ww~ er I W.Wwre is cow P $ Mdeeq vim PPM" yr punt r W 00W. W -7e~ OFA.-r" ermow% ar %.r - -- w

9 M-95OR., (1-93) Bureau of Maintenance and Operations (Central Permit Office) COUNTY CITY-BORO.-TWP. S.R.-SEG.-OFF. PERMIT NO. PERMITTEE AGREEMENT OF RELEASE (Consequential Damages Free Release) Interference with Access 67 Pa. Code Section (d) (j), (m) and (n) by THIS INDENTURE, made owner(s) of property affected by the construction or improvement of the above mentioned State highway pursuant to the above referenced permit by the permittee, heirs, executors, administrators, successors and/or assigns, hereinafter, whether singular or plural, called the OWNER, and the Commonwealth of Pennsylvania, Department of Transportation, hereinafter, whether singular or plural, called the COMMONWEALTH,

10 i y ' a IN WITNESS WHEREOF, the OWNER has executed or caused to be executed these presents, intending i to be legally bound thereby. z Witness J. Witness 3 30 Witness Witness I I attest to the signature of the officer who has executed this agreement and certify that execution hereof has been duly authorized by the e0.. OF DI RS.. MAJORITY VOTC OF ASSOC.. ETC. Secretary By CORPORATION. ASSOCIATION. CLlre. ETC. President ACCEPTED on behalf of the COMMONWEALTH : District Permit Manager COMMONWEALTH OF PENNSYLVANIA : ss : On, before me, the undersigned Officer, personally 4ppeared known to me (or satisfactorily proven) to be the person(s) whose names) subscribed to the within instrument, and acknowledged that executed the same. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. Notary Public My Commission Expires : COMMONWEALTH OF PENNSYLVANIA : -- : SS: On, before me, the undersigned officer, personally appeared, who acknowledged himself to be the of a corporation, and that he as such officer, being authorized to do so, executed the foregoing instrument on behalf of the said corporation. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. Notary Public My Commission Expires : COMMONWEALTH OF PENNSYLVANIA : : as: Recorded in the Office for Recording of Deeds in and for aforesaid County in Deedbook Page Witness my hand and seal of Office on Recorder of Deeds I certify that, upon recording, the within instrument should be mailed to : District Permit Manager Pennsylvania Department of Transportation Agent for Commonwealth of Pennsylvania Department of Transportation

11 Draft Form 95OD1(2-93) COUNTY CITY-BORO.-TWP. S.R.-SEG.-OFF. PERMIT NO. PERMITTEE DEED Fee Simple No Monetary Consideration by THIS INDENTURE, made this day of, 199, owner(s) of property affected by the construction or improvement of the above mentioned State Highway Route, under the referenced highway occupancy permit, heirs, executors, administrators, successors and/or assigns, hereinafter, whether singular or plural, called GRANTOR, and the Commonwealth of Pennsylvania, Department of Transportation, hereinafter called the COMMONWEALTH, W I T N E S S E T H : WHEREAS the COMMONWEALTH has received an application from the permittee for issuance of a highway occupancy permit for access to the above referenced State highway ; and WHEREAS the parties hereto have agreed that, as a condition to issuance of the referenced permit, the GRANTOR will convey in fee simple and such lesser estate(s) as designated, if any, to the COMMONWEALTH the property or portion thereof required by the COMMONWEALTH. NOW, THEREFORE, in consideration of the benefits to the property of the GRANTOR, the GRANTOR does hereby grant and convey to the COMMONWEALTH in fee simple that portion of the aforesaid premises designated as required right-of-way on the plot plan attached hereto and made a part hereof ; and those areas, if any, designated as required for other than right-of-way in the easement(s) identified by -co ueep mine minerais, incluaing removal or gas and oil by means of wells located off the right-of-way, from a minimum depth to be determined by the COMMONWEALTH. The GRANTOR does further indemnify the COMMONWEALTH, its agents, employees and representatives, against any claim, demand, or judgment of any type made by any lessee or easement holder of the

12 aforesaid property who is not a permittee under the referenced permit and who may be adversely affected by construction of the improvements to the demised premises or in the State highway right of way, pursuant to the referenced permit. IN WITNESS WHEREOF The GRANTOR HAS executed or caused to be executed these presents, intending to be legally bound thereby. Witness 1 witness Witness Witness u I attest to the signature of the officer who has d executed this deed and certify that execution hereof has been duly authorized, by the J V u O SO., OF DIMS, MAJORITY VOTI OF *UOC., etc. CORPORATION, AUOCIATION. Clue. ITC. e 0 H Secretary President INDIVIDUAL(S), ASSOCIATION, CLUB, etc. COMMONWEALTH OF PENNSYLVANIA : On, before me, On, before me, the undersigned Officer, personally appeared the undersigned officer, personally appeared who acknowledged himself to be the of known to me (or satisfactorily proven) to be the person(s) whose name(s) subscribed to the within instrument, and acknowledged that executed the same. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. ss: a corporation, and that he as such officer, being authorized to do so, executed the foregoing instrument on behalf of the said corporation. IN WITNESS WHEREOF. I have hereunto set my hand and official seal. CORPORATION COMMONWEALTH OF PENNSYLVANIA ss: Notary Public My Commission Expires : Notary Public ' My Commission Expires : COMMONWEALTH OF PENNSYLVANIA : w Recorded in the Of rice for Recording of Deeds in and for aforesaid County in Oeedbook Page Witness my hand and seal of Office on I certify that, upon recording, the within instrument should be mailed to : Right-of-Way Administrator Pennsylvania Department of Transportation Agent for Commonwealth of Pennsylvania Department of Transportation

13 Draft Form 950D2(2-93) COUNTY CITY-BORO.-TWP. S.R.-SEG.-OFF. PERMIT NO. PERMITTEE.I I'll 4 DEED OF EASEMENT (No Monetary Consideration) by THIS INDENTURE, made this day of 199 owner(s) of property affected by the construction or improvement of the above mentioned State Highway Route, under the referenced highway occupancy permit, heirs, executors, administrators, successors and/or assigns, hereiṉ after, after, whether singular or plural, called GRANTOR, and the Commonwealth of Pennsylvania, Department of Transportation, hereinafter called the COMMONWEALTH, W I T N E S S E T H : WHEREAS the COMMONWEALTH has received an application from the permittee for issuance of a highway occupancy permit for access to the above mentioned State highway ; and WHEREAS the parties hereto have agreed that, as a condition to issuance of the referenced permit, the GRANTOR will convey tol the COMMONWEALTH an easement for transportation purposes unlimited in vertical dimension and such lesser estate(s) as designated, if any, from the property or portion thereof required by the COMMONWEALTH, NOW, THEREFORE, in consideration of the benefits to the property of the GRANTOR, the GRANTOR does hereby grant and convey to the COMMONWEALTH an easement for transportation purposes unlimited in, vertical dimension from that portion of the aforesaid property designated as required right-of-way on the plot plan attached hereto and made a part hereof ; and those areas, if any, designated as required for other than right-of-way in the easement(s) identified by the plot plan attached hereto as Exhibit "A", being a portion of the property conveyed or devised to the GRANTOR by of dated recorded in book page together with the improvements, hereditaments and appurtenances to the said easement(s), except those which may have been agreed to be retained by the GRANTOR. And the GRANTOR warrants generally the easement hereby conveyed. Provides, however that the GRANTOR shall retain the right to deep mine minerals, including removal of gas and oil by means of wells located off the right-of-way, from a minimum depth to be determined by the COMMONWEALTH. The GRANTOR does further indemnify the COMMONWEALTH, its employees, agents and representatives against any claim, demand, or judgment of any type made by any lessee or easement holder of the aforesaid property who is not a permittee under the referenced permit and who may be adversely affected by construction of the improvements to the demised premises or in the State highway right of way, pursuant to the referenced permit.

14 w IN WITNESS WHEREOF The GRANTOR HAS executed or caused to be executed these presents, intending to be legally bound thereby. Witness Witness 0 0 i Witness 0 E Witness Y S I attest to the signature of the officer who has executed thisdeed and certify that execution hereof has been duty authorised, by the e0.. Of WAS, MAJORITY VOTE Of "11110C, ETC. CORPORATION. A**OCSATiON. Clue. STC. Secretary my, President INDIVIDUAL(S), ASSOCIATION, CLUB, etc. COMMONWEALTH OF PENNSYLVANIA : On, before me. the undersigned Officer, personally appeared known to me (or satisfactorily proven) to be the person(s) whose name(s) subscribed to the within instrument, and acknowledged that executed the same. IN WITNESS WHEREOF. I have hereunto set my hand and official seal. Notary Public My Commission Expires: COMMONWEALTH OF PENNSYLVANIA Recorded in the Office for Recording of Deeds in and for aforesaid County in Oeedbook Page Witness my hand and seal of Office on Recorder of Deeds ss: sx CORPORATION COMMONWEALTH OF PENNSYLVANIA On, before me. the undersigned officer, personally appeared. who acknowledged himself to be the of a corporation, and that he as such officer, being authorized to do so, executed the foregoing instrument on behalf of the said corporation. IN WITNESS WHEREOF. I have hereunto set my hand and official seal. Notary Public J - My Commission Expires : I certify that, upon recording, the within instrument should be mailed to : ss : Right-of-Way Administrator Pennsylvania Department of Transportation Agent for Commonwealth of Pennsylvania Department of Transportation