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CITY: <br />CITY OF LAKEWOOD, OHIO <br />(Signature) <br />(Printed Name) <br />DESIGN - BUILDER (DB) <br />(Name of Firm) <br />(Type of Organization) <br />By: <br />(Signature) <br />(Printed Name) <br />(Title) (Title) <br />Attach notary acknowledgment for all <br />signatures of the DB. If signed by other than <br />the sole proprietor, a general partner, or <br />corporate officer, attach original notarized <br />Power of Attorney or Corporate Resolution. <br />221Page <br />