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HomeMy WebLinkAboutBlack Hawk Contraction and Development Co.-2/17/2014Mayor BUCK CLARK COUNCIL MEMBERS V.C...9oo000000 DAVID JONES Ward 1 CAROLYN COLE Ward 2 HAROLD GETTY Ward 3 QUENTIN HART Ward 4 RON WELPER Ward 5 BOB GREENWOOD At -Large STEVE SCHMITT At Large PT -4 W1-3EVar is CORliftilUNITY PINING AND DEVELOPMENT 715 Mulberry Street Waterloo, Iowa 50703-5783 a (319) 291-4366 Fax (319) 291-4262 . NOEL C. ANDERSON, Community Planning & Develapment Direaor CITY F WATERLOO Council Comunication City Council Meeting: December Prepared: December 11, 2013 Dept is ead Signature: # of Attac; eats: lfa SUBJECT: Request to set a date of public hearing as January 13, 2014 to e,i ter into a development agreement with ';;lack awk Contracting and Development to authorize the sale and conveyance of a portion of City owned property for $1.00 alo+i:g Lafayette Street near itsintersection with East 3rd Street, for the_constranction.of 6 _. townhouse dwellings, along with tax rebates to developer. Submitted by: Noel Anderson, Community Planning & Development Director Recommended City Council Action: Approval of request Summary Statement: Transmitted herewith is a request to set a date of public hearing as November 25, 2013 to enter into a development agreement with Black Hawk Contracting and Development to authorize the sale and conveyance of City owned property for $1.00 along Lafayette Street, near its intersection with East 3rd Street, for the construction of 6 townhouse dwellings. The property in question has served as a city -owned parking lot with little to no leasing for its location. As you are aware, Black Hawk Contracting and Development has been actively redeveloping this area, and has built 5 new homes on East 8th Street, and 3 new homes on Lafayette Street near East 8th, for the City of Waterloo. Black Hawk Contracting & Development is also actively working to build new townhome units on Lafayette and East 7th Street. Therefore, we would ask that the City Council set a date of public hearing, and publish and official notice pertinent to the request to sell and convey the area described herein. Expenditure Required. None. Source of Funds: N/A Policy Issue: Sale of City Property C]TY WEBS11i : wwwd..waterloo.ia_us WE'RE WORKING FOR YOU! An Equal Opportunity/Affirmative Action Employer Our situation does not allow for us to expand or obtain other areas of parking. It is only proper that We come to agreement that will protect Queen of Peace in the future. The map presented shows this plainly and simply. The subject of this presentation is should this happen in our back yard for the sum of One Dollar and effect this Parish for years to come. There are a lot of other areas in this city where development of this type would be very welcome with land available. • Not putting it in a, area: which will effect the well being of A Parish that has been a part of this city for over a.century and shows every- sign of being herefor another. STATE OF IOWA, Black Hawk County I do solemnly swear that the annexed copy of 1426452 NOTICE OF PUBLIC HEARING TO WHOM IT notice was published in the WATERLOO/CEDAR FALLS a daily newspaper printed in WATERLOO, Black Hawk County, Iowa, for 1 issues commencing on 01/02/2014, in the issues of 01/02/2014 of said newspaper, and that the annexed rate of advertising is the regular legal rate of said newspaper, and that the following is a correct bill for publishing said notice. Printer's Bill $13.42 Subscribed and sworn to before me this day 4 TANYA L Gran =AMMON NO.701458 I MY COMMON ( IFIF-S NCVE 3E11 2015 Notar ' Public Received of the sum of Dollars in full for publication of the above invoice. Notary Seal: COURIER r NOTICE OF PUBLIC HEARING TO WHOM IT MAY CONCERN: Notice is hereby given that on the 13th day of January, 2014, at 5:30 p.m., in the Council Chambers In the City Hall in the City of Waterloo, Iowa, a public hearing will be held by the Council of the City of Waterloo, Iowa, to approve a Develop- nient Agreement with Black Hawk Con- tracting and Development for the sale and conveyance of a portion of City - owned property along Lafayette Street near its intersection with East 3rd Street for $1.00, for the purpose of constructing six (6) townhouse dwellings, legally de- scribed as follows: Lots B and 9, in Block 31, Original Plat on the East side of the Cedar River, City of Waterloo, Black Hawk County, State of Iowa. Anyone who is interested may appear at said time and place and be heard or may .tile written objection with the City Clerk, City Hall, Waterloo, Iowa, before the date set for said hearing. By order of the Council of the City of Wa- terloo this 16th day of December, 2013. Suzy Schares City Clerk Preparar Information: Christopher S. Wendland, PO Box 596, Waterloo, Iowa 50704 (319) 234.5701 Name Address City Phone DEVELOPMENT AGREEMENT This Development Agreement (the "Agreement") is entered into as of w- ).-t 11 i Z ((/, by and between Black Hawk Contracting & Development, Co. (the "Compaiy") and the City of Waterloo, Iowa (the "City"). John R. Rooff 111 is a principal of Company and executes the personal guaranty at the end of this Agreement for the purposes stated therein. RECITALS A. City considers economic development within the City a benefit to the community and is willing for the overall good and welfare of the community to provide financial incentives so as to encourage that goal. B. Company is willing and able to finance and construct buildings and related improvements on property located in the Downtown Urban Renewal and Redevelopment Plan area, generally located at Lafayette Street and East 3rd Street, and legally described on Exhibit "A" attached hereto (the "Property"). AGREEMENT NOW, THEREFORE, in consideration of the mutual covenants set forth herein, the parties agree as follows: 1. Sale of Property; Title. Subject to the terms hereof, City shall convey the Property, or cause it to be conveyed, to Company for the sum of $1.00 (the "Purchase Price"). Conveyance shall be by special warranty deed, free and clear of all encumbrances arising by or through City except: (a) easements, conditions and restrictions of record which do not, in Company's opinion, interfere with Company's DEVELOPMENT AGREEMENT Page 2 proposed use; (b) current and future real estate real property taxes and assessments subject to the agreements made herein; (c) general utility and right-of-way easements serving the Property; and (d) restrictions imposed by the City zoning ordinances and other applicable law. City shall have no duty to convey title to Company until Company delivers to City reasonable and satisfactory proof of financial ability to undertake and carry on the Project (defined below), which may take the form of a lending commitment letter. City shall, at its own expense, prepare an updated abstract of title, or in lieu thereof Company may, at its own expense, obtain whatever form of title evidence it desires. If title is unmarketable or subject to matters not acceptable to Company, and if City does not remedy or remove such objectionable matters in timely fashion following written notice of such objections from Company, Company may terminate this Agreement. 2. Improvements by Company. Company shall subdivide the Property into six (6) separate lots to allow for the construction of one (1) townhome of not less than 1,000 square feet on each lot. Each separate lot upon which a home will be constructed (a "phase") shall be completed to a finished state, including installation of driveways and sidewalks, removal of all construction debris, proper leveling or shaping of groundscape, and grassing and/or landscaping (collectively, the "Improvements"). The Improvements shall be constructed in accordance with all applicable City, state, and federal building codes and shall comply with all applicable City ordinances and other applicable law. It is contemplated that the Improvements will have a total market value upon completion of no less than $140,000 per townhome. The Property, the Improvements, and all site preparation and development -related work to make the Property usable for Company's purposes as contemplated by this Agreement are collectively referred to as the "Project". All Improvement designs for buildings and layout shall be approved by a City -designated Design Build Management Team (DBMT) as appointed by the Mayor. 3. Timeliness of Construction; Possibility of Reverter. The parties agree that Company's commitment to undertake the Project and to construct the Improvements in a timely manner constitutes a material inducement for the City to convey the Property to Company and that without said commitment City would not do so. Measured from the date the Property is deeded to Company, Company must obtain a building permit and begin construction on the first phase within four (4) months, on the second Phase within eight (8) months, and on all remaining phases by June 1, 2015. Construction of all phases shall be completed no later than September 30, 2015. If Company has not, in good faith, begun the construction of any phase of the Improvements on the schedule stated above, then title to the Property shall revert to the City, except as provided in this Agreement; provided, however, that if construction has not begun at the end of any phase commencement period but the development of the Project is still imminent, the City Council may, but shall not be required to, consent to an extension of time for the construction of the Improvements, and if an extension is granted but construction of the Improvements has not begun within such extended period, then the title to the Property shall revert to the City after the end of said extended period. If Company determines at any time that the Project is not DEVELOPMENT'AGREEMENT Page 3 economically feasible, then after giving thirty (30) days' advance written notice to City, Company may convey the Property to City by special warranty deed, and thereupon neither party shall have any further obligation under this Agreement except as expressly provided. If development has commenced within the required period or any extended period and is stopped and/or delayed as a result of an act of God, war, civil disturbance, court order, labor dispute, fire, or other cause beyond the reasonable control of Company, the requirement that construction of any phase or of the entire Project shall be tolled for a period of time equal to the period of such stoppage or delay, and thereafter if construction is not completed within the allowed period of extension then title to the Property shall revert to the City. 4. Platting and Release. The parties expect that Company will plat the Property for purposes of the Project. As nearly as reasonably possible, the area platted for each phase shall be comprised of a roughly equivalent area as measured in square feet. In connection with any sale by Company of that part of the Property corresponding with a completed phase of Improvements, City agrees to release such part of the Property from the conditions and restrictions set forth in this Agreement. A release of any such part of the Property shall not affect the continued effectiveness and enforceability of this Agreement as to any part of the Property that is not specifically released. 5. Reverter of Title; Indemnity. Title shall not revert to City as to any phase of Improvements that has been substantially completed as provided in this Agreement. In the event of any reverter of title, Company agrees that it shall, at its own expense, promptly execute all documents, including but not limited to a special warranty deed, or take such other actions as the City may reasonably request to effectuate said reverter and to deliver to City title to the Property, or phase thereof, that is free and clear of any lien, claim, or encumbrance arising by or through Company. Company shall pay in full, so as to discharge or satisfy, all liens, claims, charges, and encumbrances on or against the Property or phase conveyed. If Company fails to deliver such documents, including but not limited to a special warranty deed, to City within thirty (30) days of written demand by City, then City shall be authorized to execute, on Company's behalf and as its attorney-in-fact, the special warranty deed required by this Section, and for such limited purpose Company does hereby constitute and appoint City as its attorney- in-fact. Company further agrees that it shall indemnify City and hold it harmless with respect to any demand, claim, cause of action, damage, or injury made, suffered, or incurred as a result of or in connection with the Project, Company's failure to carry on or complete same, or any lien, claim, charge, or encumbrance on or against the Property of any type or nature whatsoever that attaches to the Property by virtue of Company's ownership of same. If City files suit to enforce the terms of this Agreement and prevails in such suit, then Company shall be liable for all legal expenses, including but not limited to reasonable attorneys' fees. Company's duties of indemnity pursuant to this Section shall survive the expiration, termination or cancellation of this Agreement for any reason. DEVELOPMENT'AGREEMENT Page 4 6. No Encumbrances; Limited Exception. Until completion of the Improvements, Company agrees that it shall not create, incur, or suffer to exist any lien, encumbrance, mortgage, security interest, or charge on the Property, other than such mortgage or mortgages as may be reasonably necessary to finance Company's completion of the Improvements and of which Company notifies City in advance of Company's execution of any such mortgage. Company may not mortgage the Property or any part thereof for any purpose except in connection with financing of the Improvements. 7. Water and Sewer. Company will be responsible for extending water and sewer service from the public right of way to any location on the Property and for payment of any associated connection fees. 8. Tax Rebates. Provided that Company has completed the Improvements as set forth herein, City agrees to rebate property tax (with the exceptions noted below) as follows: Year One 50% rebate Year Two 50% rebate Year Three 50% rebate Year Four 50% rebate Year Five 50% rebate Year Six 50% rebate Year Seven 50% rebate Year Eight 50% rebate Year Nine 50% rebate Year Ten 50% rebate for any taxable value over the January 1, 2013 land value of $33,660 for the Property as a whole, or $5,610 per phase parcel after platting. Rebates are payable in respect of a given year only to the extent that Company or a future owner of the Property or a phase parcel has actually paid general property taxes due and owing for such year. To receive rebates for a given year, Company must, within twelve (12) months after the tax payment due date, submit a completed rebate request to City on the form provided by or otherwise satisfactory to City. The taxable value of the Property as a result of the Improvements must be increased by a minimum of 10% and must increase the annual tax by a minimum of $500.00. This rebate program is not applicable to any special assessment levy, debt service levy, or any other levy that is exempted from treatment as tax increment financing under the provisions of applicable law. Rebates will be paid on a phase -by -phase basis after Company plats the Property as contemplated by this Agreement. The first year in which a rebate may be given ("Year One") shall be the first full year for which the assessment is based upon the completed value of the Improvements relating to a given phase, and not based on a prior year for which the assessment is based solely upon (x) the value of the Property DEVELOPMENT AGREEMENT Page 5 or a phase parcel or upon (y) the value of the Property or a phase parcel and a partial value of the Improvements due to partial completion of the Improvements or a partial tax year. The parties agree that rebates are intended for the benefit of Company to compensate it for certain of its development costs and will not run with the land. City shall pay rebates to the Company even if Company conveys the property to a third party, unless City receives from Company a written assignment of its rebate right, in a form reasonably acceptable to City, to the owner of the phase parcel. 9. Representations and Warranties of City. City hereby represents and warrants as follows: A. City is not prohibited from consummating the transaction contemplated in this Agreement by any law, regulation, agreement, instrument, restriction, order or judgment. B. Each person who executes and delivers this Agreement and all documents to be delivered hereunder is and shall be authorized to do so on behalf of City. 10. Representations and Warranties of Company. Company hereby represents and warrants as follows: A. Company is not prohibited from consummating the transaction contemplated in this Agreement by any law, regulation, agreement, instrument, restriction, order or judgment. B. Company is duly organized, validly existing, and in good standing under the laws of the state of its organization and is duly qualified and in good standing under the laws of the State of Iowa. C. Company has full right, title, and authority to execute and perform this Agreement and to consummate all of the transactions contemplated herein, and each person who executes and delivers this Agreement and all documents to be delivered to City hereunder is and shall be authorized to do so on behalf of Company. 11. No Assignment or Conveyance. Company agrees that it will not sell, convey, assign or otherwise transfer its interest in unimproved phase portions of the Property prior to completion of the improvements pertaining to such phase of the Project, whether in whole or in part, to any other person or entity without the prior written consent of City. Reasonable grounds for the City to withhold its consent shall include but are not limited to the inability of the proposed transferee to demonstrate to the City's satisfaction that it has the financial ability to observe all of the terms to be performed by Company under this Agreement. DEVELOPMENT AGREEMENT Page 6 12. Materiality of Company's Promises, Covenants, Representations, and Warranties. Each and every promise, covenant, representation, and warranty set forth in this Agreement on the part of Company to be performed is a material term of this Agreement, and each and every such promise, covenant, representation, and warranty constitutes a material inducement for City to enter this Agreement. Company acknowledges that without such promises, covenants, representations, and warranties, City would not have entered this Agreement. Upon breach of any promise or covenant, or in the event of the incorrectness or falsity of any representation or warranty, City may, at its sole option and in addition to any other right or remedy available to it, terminate this Agreement and declare it null and void. 13. Notices. Any notice under this Agreement shall be in writing and shall be delivered in person, by overnight air courier service, by United States registered or certified mail, postage prepaid, or by facsimile (with an additional copy delivered by one of the foregoing means), and addressed: (a) if to City, at 715 Mulberry Street, Waterloo, Iowa 50703, facsimile number 319-291-4571, Attention: Mayor, with copies to the City Attorney and the Community Planning and Development Director. (b) if to Company, to Black Hawk Contracting & Development Co., 1509 Commercial Street, Waterloo, Iowa, 50701, Attention: John Rooff, with a copy to Eric W. Johnson, Esq., Beecher Law Firm, 620 Lafayette Street, Waterloo, Iowa 50703. Delivery of notice shall be deemed to occur (i) on the date of delivery when delivered in person, (ii) one (1) business day following deposit for overnight delivery to an overnight air courier service which guarantees next day delivery, (iii) three (3) business days following the date of deposit if mailed by United States registered or certified mail, postage prepaid, or (iv) when transmitted by facsimile so long as the sender obtains written electronic confirmation from the sending facsimile machine that such transmission was successful. A party may change the address for giving notice by any method set forth in this section. 14. No Joint Venture. Nothing in this Agreement shall, or shall be deemed or construed to, create or constitute any joint venture, partnership, agency, employment, or any other relationship between the City and Company nor to create any liability for one party with respect to the liabilities or obligations of the other party or any other person. 15. Amendment, Modification, and Waiver. No amendment, modification, or waiver of any condition, provision, or term of this Agreement shall be valid or of any effect unless made in writing, signed by the party or parties to be bound or by the duly authorized representative of same, and specifying with particularity the extent and nature of the amendment, modification, or waiver. Any waiver by any party of any default by another party shall not affect or impair any rights arising from any subsequent default. bEVELOPMENT AGREEMENT Page 7 16. Severability. Each provision, section, sentence, clause, phrase, and word of this Agreement is intended to be severable. If any portion of this Agreement shall be deemed invalid or unenforceable, whether in whole or in part, the offending provision or part thereof shall be deemed severed from this Agreement and the remaining provisions of this Agreement shall not be affected thereby and shall continue in full force and effect. If, for any reason, a court finds that any portion of this Agreement is invalid or unenforceable as written, but that by limiting such provision or portion thereof it would become valid and enforceable, then such provision or portion thereof shall be deemed to be written, and shall be construed and enforced, as so limited. 17. Captions. All captions, headings, or titles in the paragraphs or sections of this Agreement are inserted only as a matter of convenience and/or reference, and they shall in no way be construed as limiting, extending, or describing either the scope or intent of this Agreement or of any provisions hereof. 18. Binding Effect. This Agreement shall be binding and shall inure to the benefit of the parties and their respective successors, assigns, and legal representatives. 19. Counterparts. This Agreement may be executed in one or more counterparts, each of which shall be deemed an original and all of which, taken together, shall constitute one and the same instrument. 20. Entire Agreement. This Agreement, together with the exhibits attached hereto, constitutes the entire agreement of the parties and supersedes all prior or contemporaneous negotiations, discussions, understandings, or agreements, whether oral or written, with respect to the subject matter hereof. 21. Time of Essence. Time is of the essence of this Agreement. IN WITNESS WHEREOF, the parties have executed this Development Agreement by their duly authorized representatives as of the date first set forth above. CITY OF WATERLOO, IOWA By: Ernest G. Clark, Mayor Attest Suzy S hares, City Clerk BLACK HAWK CONTRACTING & DEVELOPME,CO. By: ooff, III, Presid DEVELOPMENT AGREEMENT Page 8 [personal guaranty on next page] PERSONAL GUARANTY. The undersigned, being either an officer, shareholder, manager, or member of Company, hereby agree for themselves and their heirs, personal representatives, and assigns, to unconditionally guarantee to City, its successors and assigns, the full and prompt performance by Company, its successors and assigns, of all promises and covenants on the part of Company to be performed pursuant to the foregoing Agreement, including but not limited to the duties of indemnity set forth therein. Liability of multiple guarantors hereunder is joint and several. EXHIBIT "A" Legal Description of Property Lots 8 and 9, in Block 31, Original Plat on the East Side of the Cedar River, City of Waterloo, Black Hawk County, Iowa. Prepared by .Janes E. Walsh, Jr., City Attorney, 715 Mulberry, Waterloo, IA, 50703, telephone (319) 291-4327 TAX STATEMENT: Waterloo, lowa 50702 For the consideration consideration, does hereby Black Hawk Contracting and Development Co., 1509 Commercial Street, SPACE ABOVE THIS LINE FOR RECORDER QUIT CLAIM DEED of ($1.00) One-Dollar(s) and other good and valuable plus costs CITY OF WATERLOO, IOWA Quit Claim to Black Hawk Contracting and Development Co. all our right, Black Hawk title, interest, estate, claim County, Iowa: in Block 31, Original Black Hawk County, exempt from Documentary Stamp hereby relinquishes all rights herein, including acknowledgment to the context. 17, 2014 and demand in the following -described real estate in Plat on the East Side of the Cedar River, Iowa. and Declaration of Value per Iowa Code §428A.2(6) (2013). of dower, homestead and distributive share in and to the real estate. hereof, shall be construed as in the singular or plural number, and as masculine or C! "f OF WA a /Gly, Lots 8 and 9, City of Waterloo, This transaction Each of the undersigned Words and phrases feminine gender, according Dated: February ATTEST: rnest G. Clark, Mayor Suzy STATE Iowa, sworn, affixed sealed City Ernest and Schrres, City Clerk OF IOWA, COUNTY OF BLACK On this 17th day of February, 2014, personally appeared Ernest G. Clark did say that they are the Mayor and to the foregoing instrument is the on behalf of the corporation by authority Council, under Council Action No. G. Clark and Suzy Schares acknowledged the voluntary act and deed of the corporation, HAWK ) ss before me, the undersigned, a Notary Public in and for the State of and Suzy Schares, to me personally known, and who, being by me duly City Clerk, respectively, of the City of Waterloo, Iowa; that the seal corporate seal of the corporation, and that the instrument was signed and of its City Council as contained in the Resolution adopted by the 142303 of the City Council on the 17"' day of February, 2014, and that the execution of the instrument to be their voluntary act and deed by it voluntarily executed. , st s t o DeAnne Kobliska COMMISSION NO. 763995 MY COMMISSION EXPIRES ��Not ry Public in and fo the State of Iowa e. REAL ESTATE TRANSFER - GROUNDWATER HAZARD STATEMENT TO BE COMPLETED BY TRANSFEROR TRANSFEROR: Name City of Waterloo Address 715 Mulberry Street, Waterloo, Iowa 50703 Number and Street or RR City, Town or P.O. State Zip TRANSFEREE: Name Black Hawk Contracting and Development Co. Address 1509 Commercial Street, Waterloo, Iowa 50702 Number and Street or RR City, Town or P.O. State ZIP Address of Property Transferred: Parking Lot Number and Street or RR City, Town or P.O. State Zip Legal Description of Property: (Attach if necessary) Lots 8 and 9, in Block 31, Original Plat on the East Side of the Cedar river, City of Waterloo, Black Hawk County, Iowa. 1. Wells (check one) X There are no known wells situated on this property. There is a well or wells situated on this property. The type(s), location(s) and legal status are stated below or set forth on an attached separate sheet, as necessary. 2. Solid Waste Disposal (check one) X There is no known solid waste disposal site on this property. _ There is a solid waste disposal site on this property and information related thereto is provided in Attachment #1, attached to this document. 3. Hazardous Wastes (check one) X There is no known hazardous waste on this property. _ There is hazardous waste on this property and information related thereto is provided in Attachment #1, attached to this document. 4. Underground Storage Tanks (check one) X There are no known underground storage tanks on this property. (Note exclusions such as small farm and residential motor fuel tanks, most heating oil tanks, cisterns and septic tanks, in instructions.) There is an underground storage tank on this property. The type(s), size(s) and any known substance(s) contained are listed below or on an attached separate sheet, as necessary. FILE WITH RECORDER DNR form 542-0960 (July 18, 2012) 5. Private Burial Site (check one) X There are no known private burial sites on this property. _ There is a private burial site on this property. The location(s) of the site(s) and known identifying information of the decedent(s) is stated below or on an attached separate sheet, as necessary. 6. Private Sewage Disposal System (check one) All buildings on this property are served by a public or semi-public sewage disposal system. _ This transaction does not involve the transfer of any building which has or is required by law to have a sewage disposal system. _ There is a building served by private sewage disposal system on this property or a building without any lawful sewage disposal system. A certified inspector's report is attached which documents the condition of the private sewage disposal system and whether any modifications are required to conform to standards adopted by the Department of Natural Resources. A certified inspection report must be accompanied by this form when recording. There is a building served by private sewage disposal system on this property. Weather or other temporary physical conditions prevent the certified inspection of the private sewage disposal system from being conducted. The buyer has executed a binding acknowledgment with the county board of health to conduct a certified inspection of the private sewage disposal system at the earliest practicable time and to be responsible for any required modifications to the private sewage disposal system as identified by the certified inspection. A copy of the binding acknowledgment is attached to this form. There is a building served by private sewage disposal system on this property. The buyer has executed a binding acknowledgment with the county board of health to install a new private sewage disposal system on this property within an agreed upon time period. A copy of the binding acknowledgment is provided with this form. _ There is a building served by private sewage disposal system on this property. The building to which the sewage disposal system is connected will be demolished without being occupied. The buyer has executed a binding acknowledgment with the county board of health to demolish the building within an agreed upon time period. A copy of the binding acknowledgment is provided with this form. [Exemption #9] This property is exempt from the private sewage disposal inspection requirements pursuant to the following exemption [Note: for exemption #9 use prior check box]: _ The private sewage disposal system has been installed within the past two years pursuant to permit number Information required by statements checked above should be provided here or on separate sheets attached hereto: i HEREBY DECLARE THAT I HAVE REVIEWED THE INSTRUCTIONS FOR THIS FORM AND THAT THE INFORMATION STATED ABOVE IS TRUE AND CORRECT. Signature: Telephone No.: 319-291-4366 (Transferor or Agent) FILE WITH RECORDER DNR form 542-0960 (July 18, 2012)