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CC - Affidavit of Annual Report YMCA(E IDI� I.�1\ APPROVED DATE 01/27/22 FURIMIER:SH+ 022nWl STATE OF IDAHO ) COUNTY OF ADA ) AFFIDAVIT OF LEGAL INTEREST I, David L. Duro CEO & President of The Young Men's Christian Association of Boise City, Idaho (name) _ 1 177 W. State Street Boise Idaho 83702 (address) (city) (state) being first duly sworn upon, oath, depose and say: That I am the record owner of the property described on the attached, and I grant lily permission to: Kelly Kehrer, P.E., P.L.S., KM Engineering, 9233 W. State Street (name) Boise, ID 83714 (address) to submit the accompanying application(s) pertaining to that property. 2. I agree to indemnify, defend and hold the City of Meridian and its employees harmless from any claim or liability resulting from any dispute as to the statements contained herein or as to the ownership of the property which is the subject of the application. 3. 1 hereby grant permission to City of Meridian staff to enter the subject property for the purpose of site inspections related to processing said application(s). Dated this day of Match, 2017. THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF BOISE CITY, IDAHO, a tax-exempt Idaho non-profit corporation Bq: 'David L. Duro Its: CEO & President S[JQ,J • 'P ®•{�°ND SWORN to before me the day and year first above written. ��' © •® ® o PRY © ® a (Notary blic for Idaho) v ® PUB Residingat:nn�^ e� My Commission Expires: l� ' OL ®B°OB sT A T E 0F 0 °1098B8880W"' Community Development ■ Planning Division ■ 33 E. Broadway Avenue, Ste. 102 Meridian, Idaho 83642 Phone: 208-884-5533 Fax: 208-888-6854 www.meridimicitv.oi-glplannine 09287-042;930493 Annual Report for C 4342 Page 1 of 1 L�(E IDI� n APPROVED [4342 DATE: 01/27/22 FILE NUMBER: SH-2022-0001 OF STATE FFERSON BOISE, ID 83720-0080 NO FILING FEE IF RECEIVED BY DUE DATE Due no later than Feb 28, 2017 Annual Report Form 1. Mailing Address: Correct in this box if needed. 2. Registered Agent and Address (NO PO BOX) DAVID L DURO 1177 W. STATE STREET BOISE ID 83702 YOUNG MEN'S CHRISTIAN ASSOCIATION OF BOISE CITY, IDAHO (THE) DAVID L DURO 1177 W. STATE STREET 3. New Registered Agent Signature:* BOISE ID 83702 1. Corporations: Enter Names and Business Addresses of President, Secretary, and Directors. Office Held Name Street or PO Address Cif DIRECTOR JOHN ASHBY 1177 W. STATE STREET BC DIRECTOR JEFF TONKIN 1177 W. STATE STREET BC DIRECTOR RONDA CONGER 1177 W. STATE STREET BC DIRECTOR NED PONTIOUS 1177 W. STATE STREET BC DIRECTOR SUSAN SMITH 1177 W. STATE STREET BC DIRECTOR HEATHER SABALA 1177 W. STATE STREET BC DIRECTOR ERIK PRAY 1177 W. STATE STREET BC DIRECTOR CHARINA NEWELL 1177 W. STATE STREET BC DIRECTOR SCOTT KREILING 1177 W. STATE STREET BC DIRECTOR EVELYN JOHNSON 1177 W. STATE STREET BC DIRECTOR JANE HARDISON 1177 W. STATE STREET BC DIRECTOR JANIE GROFF 1177 W. STATE STREET BC DIRECTOR JIM CLEARY 1177 W. STATE STREET BC DIRECTOR JIM CHALFANT 1177 W. STATE STREET BC DIRECTOR CATHY AM MIRATI 1177 W. STATE STREET BC DIRECTOR RICH RAIMONDI 1177 W. STATE STREET BC DIRECTOR KRIS ORMSETH 1177 W. STATE STREET BC DIRECTOR MAUREEN O'KEEFFE 1177 W. STATE STREET BC DIRECTOR KAY ALSPAUGH 1177 W. STATE STREET BC DIRECTOR BOB WRIGHT 1177 W. STATE STREET BC PRESIDENT DAVID L DURO 1177 W. STATE STREET BO DIRECTOR JAMES PETERSON 1177 W. STATE STREET BO DIRECTOR KATE HAAS 1177 W. STATE STREET BO DIRECTOR BETH OPPENHEIMER 1177 W. STATE STREET BO TREASURER TOM O'NEIL 1177 W. STATE STREET BO DIRECTOR DAVE SELF 1177 W. STATE STREET BO DIRECTOR THERESA MADRID 1177 W. STATE STREET BO DIRECTOR LEIF ELGETHUN 1177 W. STATE STREET BO DIRECTOR TOM CORRICK 1177 W. STATE STREET BO DIRECTOR BILL BANKHEAD 1177 W. STATE STREET BO DIRECTOR TRAVIS DRYDEN 1177 W STATE STREET BO DIRECTOR SHARON BURKE 1177 W STATE STREET BO DIRECTOR ALEX ZAMORA 1177 W. STATE STREET BO 5. Organized Under the Laws of: 16. Annual Report must be signed.* ID C 4342 Treasurer (optional). State ... ............ Country ........ Postal Code .......... ISE ID USA 83702 ISE ID USA 83702 ISE ID USA 83702 ISE ID USA 83702 ISE ID USA 83702 ISE ID USA 83702 ISE ID USA 83702 ISE ID USA 83702 ISE ID USA 83702 ISE ID USA 83702 [SE ID USA 83702 :SE ID USA 83702 .SE ID USA 83702 SE ID USA 83702 SE ID USA 83702 SE ID USA 83702 SE ID USA 83702 SE ID USA 83702 :SE ID USA 83702 SE ID USA 83702 SE ID USA 83702 SE ID USA 83702 SE ID USA 83702 SE ID USA 83702 SE ID USA 83702 SE ID USA 83702 SE ID USA 83702 SE ID USA 83702 SE ID USA 83702 SE ID USA 83702 SE ID USA 83702 SE ID USA 83702 SE ID USA 83702 Signature: David Duro (Amy Colgan as Proxy) Date: 01/04/2017 Name (type or print): David Duro (Amy Colgan as Proxy) Title: President and CEO Processed 01/04/2017 * Electronically provided signatures are accepted as original signatures. t1ff-Q•//XXMx r On,- ;Al Ikn rrn11/Vf/9vn=0/ S( )n17010, 0/ S( VMI .PnRTC C4147 170 1041nil X 5/7/7017