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LP-2 Amendment to Certificate of Limited FILED \ Partnership (LP) sawgswy of SW To change information of record for your LP, fill out this form, and OfQ111111Df1nNt submit for filing along with: OCT 2 20�6 — A$30filingfee. — A separate, non-refundable $15 service fee also must be 1� Included, if you drop off the completed form. Items 3-7: Only fill out the information that is changing. Attach extra pages If you need more space or need to include any other matters. This space For office Use only For questions about this form, go to www.sos. ca.govlbusfneswbarfrlfng-tlps.htin © LP's FRO No, (issued by CA Secretary of State) ® LP'a Exact Name (on file with CA Secretary of Stare) 199022500028 Windsor Properties, L.P. New LP Name m Proposed New LPName The new LP name: must end with: "Umhed Partnership," 'UP," or "L.P,," and may not contein't+enk," 'trust' 'trustee," Incorporated." "Inc.,' "corpom0on," or "core." New LP Addresses ® a. CA street Address ofOeslgnated Office In CA clty(no obbreNebons) state zip b. Mailing Address of LP, if different from 4a chy (no obbravi dons) state Zip c Nana AilenifAddresa for Service of Process (The agent must be a CA resident or qualified 1505 corporation In CA.) ® a, GLK Corporate/Search Inca c e m Agent's Memo b. CA E c Agent's 3treetAddreas X agent is not a corporation) city (no ebbrBNatfors) state Zip o OenF¢ral Partner Changes -e, New general partner. Name Address City (no abbrovfationel state ZP b. Address change: o� Name New Address city (no a ievlatfons) state Zip o a Name change: Old name: New name: d. Name of dissociated general partner. m Dissolved LP (Either check box a or check box b and complete the Information. Note: To terminate the LP, also file a Certificate of Cancellation (Form LP4M, available at www:sos.w.govibuslnessWorms.htn.) 0 a. © The LP is dissolved and wrapping up Its affairs.. b. © The LP Is dissolved and has no general partners. The following person has been appointed to wrap up the affairs of the LP: Name Address Oily (no abbrovistlons) state Zip Read and sign below: This form must be signed by (1) at least one general partner, (2) by each person listed In Item so: and (3) by each person fated in item Bd N that person has not filed a Certificate of Dissociation (Forth LP-101). If Item 71; is checked, the person listed must sign. If a. trust, association, aftomey-in-fad, or any other person not listed above is signing, go to Vaww.sos.ca.govkusinessfbetriling-ttps.htm for more information. if you need more space, attach extra pages that are 1-sided and on standard letter -sized paper (B 112" x 11"). All attachments are part of this amendment. Signing this document affirms under penalty of perjury that the stated facts are true. Michael J. Kotzin, President of Acacia Commonwealth Company, HIS General Partner 30 �� b Sign here LIZ Print your name halo Date Sign here Plfnt yourname here Date Make checklmeney order payable to: Secretary of State By Mail Drop -Off Upon filing, we will return one (1) uncemMed copy of your Secretary of slate Secretary of State filed document for free, and Will certify the copy upon Business Entities, P.O. Box 944225 1500 11th Street, 3rd Floor request and payment of a $5 certification fee. Sacramento, CA 94244-2250 Sacramento, CA 95814 Corporations Code § 15902.02 LP-2 (REV 0112013) 2013 California Secretary of State wswaca.ce.gavlhminduf be SEW PART o CITY OF NEWPORT BEACH COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION > 100 Civic Center Drive I P.O. Box 17681 Newport Beach, CA:92658-8915 c ipoa��P www.newportbeachca.govl(949)644-3200 NOTICE TO PROPERTY OWNER Dear Property Owner. An application for a building permit ye�RE een submitted In your name listing yourself as the builder of the property improvements specified 01 E Baibrin AAvd 1 NewpoN, React, .fA ClAWbI . We are providing you with an Owuilder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not Issue a building permit until you have read', initialed your understanding of each provision, signed, and returned this form to us at our official address Indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION DIRECTIONS., Read and initial each statement below to signify you understand or verify this information. l. I understand a frequent practice of unlicensed persons is to have the property owner obtain an Owner -Builder' building permit that erroneously Implies that the property owner is providing his or her own labor and material personally. 1, as an Owner -Builder, may be held liable and subject to serious < financial dsk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully < < acting as an Owner -Builder and am aware of the limits of my insurance coverage for Injuries to workers n my 2.1understand I unstand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring licensed Contractor to assume this responsibility. d�/{�3. 1 understand as an "Owner -Builder' t am the responsible party of record on the permit. I dnderstand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. tAd4, 1 understand Contractors are required by law to be licensed and bonded in California and to list eir license numbers on permits and contracts. /_5. 1 understand if I employ or otherwise engage any .persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, 1 may be considered an "employer' under state and federal law. 6..1 understands if i am considered an "employer' under state and federal law, I must register with the and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. /%/-7. 1 understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 14-8, 1 understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. Fomsbomcr builder verifdoc. 08/12/16 1 of 2 9. I understand I may obtain more information regarding my obligations as an "employer' from the In emal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1.800-321-CSLB (2752) or www.oslb.ca.gov for more information about licensed contractors. 1W 10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and Tderstand that I am the party legally and financially responsible for proposed construction activity at the following address: a01 E R41b0A 13tvd Newooct BE0.Ch. Lie Cla4Gn1 /* 11. 1 agree that, as the party legally and financially responsible for this proposed construction Activity, I will abide by all applicable laws and requirements that govern Owner -Builders as well as employers. A// 12. 1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to Any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. if you contract with someone who does not have a license; the Contractors` State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation Insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the City of Newport Beach, Building Division, for issuing the permit. Note: A copy of the property owner's driver's license or form notarization is required to be s o o E presented when the permit Is issued to verify the property' owner's signature. << e Print nameof property ownipa N iif_kc - koEZI A ` <<< Property Owner's Signature: Date: �' 1� —Z' n �< < Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the followingperson(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner-Bulider Permit for my project. Scope of Construction Project (or Description of Work): K001; CC,}QA'1, Project Location or Address: _ AO k E BOA100M g\ 4d Name of Authorized Agent: 9NtLL.he1 1-)ir, (net Tel No 94q - 454Y 1402L Address of Authorized Agent: A33tol. Et Toro: VAOa Lo` e ForeS$ CA 9:g(a30 �- 1 declare under penalty of perjury that i am the personally filled out the above information and car license, form notarization, or other verification acre, the permit is issued to verify the property owner's si Property Owner's Signature: rty owner for the address listed above and I accuracy. Note: A copy of the owner's driver's to the agency is required to be presented when Date: .Note: A copy of the owner's driver's9icamfe or form notarization is required to be presented when the permit Is issued to verify the property owner's signature. FonnskD"cr builder vedCdoe 08/12/16 2 of