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<br /> <br />Exhibit B-5 <br /> <br />STATE OF WASHINGTON <br /> <br />COUNTY OF <br />_________________________ <br /> <br />ss. <br /> <br /> <br /> <br /> I certify that I know or have satisfactory evidence that _________________________ <br />is the person who appeared before me, and said person acknowledged that said person <br />signed this instrument, on oath stated that said person was authorized to execute the <br />instrument and acknowledged it as the _________________________ of the City of Everett to <br />be the free and voluntary act of such party for the uses and purposes mentioned in the <br />instrument. <br /> <br /> Dated this _________________________ day of _________________________,_____. <br /> <br /> <br />(Signature of Notary) <br /> <br /> <br />(Legibly Print or Stamp Name of Notary) <br />Notary public in and for the state of <br />Washington, residing at <br />My appointment expires <br /> <br /> <br />