HomeMy WebLinkAbout20260506 American Land Title Association FINAL ALTA Settlement Statement- Borrower
Adopted 05-01-2015
File No./Escrow No.: 2848781 Stewart Title Company
2015 Clubhouse Dr#203
Officer/Escrow Officer:Joanne Stevens Greeley, CO 80634
(970) 356-5573
Property Address: 914 11TH AVENUE
GREELEY, CO 80631 (WELD)
(R2822186 / 096105330002)
Borrower: COUNTY OF WELD, COLORADO, BY AND THROUGH THE BOARD OF COUNTY COMMISSIONERS
OF THE COUNTY OF WELD
11500St
Greeley, CO 80631
Settlement Date: 2/26/2026
Disbursement Date: 2/26/2026
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Description_ .., "'Borrower
P.O.C. Debit Credit
Deposits,Credits,Debits
Sale Price of Property $835,000.00
Prorations
County Taxes 1/1/2026 to 2/26/2026 @$11,568.40/Year $1,774.88
Title Charges
Title-Lender's Title Insurance to Stewart Title Company
Title-Owner's Title Insurance to Stewart Title Company $2,254.00
Title-e Record Fee(Buyer/Borrower)to Rocky Mountain Recording Services(R) $7.00
Title-Recording Service Fee to Rocky Mountain Recording Services(R) $35.00
Title-Settlement or closing fee to Stewart Title Company $600.00
Title-Tax Certificate Fee to Rocky Mountain Recording Services(R) $40.00
Government Recording and Transfer Charges
Recording fees:Deed to County Recorder$43.00 $43.00
State Deed Tax/Stamps to County Recorder $83.50
P.O.C. Debit Credit
Subtotals $0.00 $838,062.50 $1,774.88
Due From Borrower $836,287.62
Totals $0.00 $838,062.50 $838,062.50
Acknowledgement
We/I have carefully reviewed the ALTA Settlement Statement and find it to be a true and accurate statement of all receipts
and disbursements made on my account or by me in this transaction and further certify that I have received a copy of the
ALTA Settlement Statement. We/I authorize Stewart Title Company to cause the funds to be disbursed in
accordance with this statement.
BORROWER(S)
County of Weld,Colorado,by and through the Board of County Commissioners of the
county of Weld
By:
Scott K.James,Chairman,Board of County Commissioners of Weld County
SETTLErN•u RDINATOR
it .)0
Joanne teven
Page 1 of 1 File#2848781
Printed on 2/26/2026 at 11:26 AM
M NM)A; co.-I-to/AS
03/l t/26 2026-0506
•
This form is the property of the Colorado Real Estate Commission. The printed portions of this form, except differentiated additions,have been
approved and pronudgated by the Commission for public use.All users are prohibited from modifying this form except as permitted by the Rules
Regarding Real Estate Brokers, 4 CCR 725-1-7.2.
CL8-Closing Instructions
Adoption Date:October 7,2025
Mandatory Use Date:January 1,2026
THIS FORM HAS IMPORTANT LEGAL CONSEQUENCES AND THE PARTIES SHOULD CONSULT LEGAL AND TAX OR
OTHER COUNSEL BEFORE SIGNING.
CLOSING INSTRUCTIONS
Date:February 26,2026
1. PARTIES, PROPERTY. High Plains Medical LLC, a Colorado limited liability company, (Seller), and County of Weld,
Colorado, by and through the Board of County Commissioners of the County of Weld, (Buyer), engage Stewart Title Company,
(Closing Company), who agrees to provide closing and settlement services in connection with the closing of the transaction for the
sale and purchase of the Property known as No. 914 11th Avenue,Greeley, CO 80631 and more fully described in the contract,dated
,including any counterproposals and amendments(Contract). All terms of the Contract are incorporated herein by reference. In
the event of any conflict between these Closing Instructions and the Contract,these Closing Instructions control,subject to subsequent
amendments to the Contract or these Closing Instructions. The Buyer's lender may enter into separate closing instructions with the
Closing Company regarding the closing of the Buyer's loan.
2. TITLE COMMITMENT, EXCEPTIONS AND POLICY. Closing Company V.Agrees ❑ Does Not agree that:
upon completion of a satisfactory title search and examination, it will furnish a Title Insurance Commitment; and it will issue a
Title Insurance Policy provided that all requirements have been fulfilled. Closing Company Agrees 0 Does Not agree to
furnish copies of Exceptions.
3. INFORMATION, CLOSING, RECORDING. Closing Company is authorized to obtain any information necessary for the
closing. Closing Company agrees to deliver and record all documents required or customarily recorded and disburse all funds
pursuant to the Contract that are necessary to carry out the terms and conditions of the Contract.
4. PREPARATION OF DOCUMENTS. The Closing Company will prepare the necessary documents to carry out the terms and
conditions of the Contract to include:
4.1. Deed. If the deed required in the Contract is a special warranty deed, general warranty deed, bargain and sale deed
(excluding a personal representative's or trustee's deed) or a quit claim deed, the deed will be prepared in accordance with the
Contract by the Closing Company. However, if the Contract requires a different form of deed (e.g.: personal representative's deed or
trustee's deed)or requires that the special warranty deed or general warranty deed list exceptions other than the"statutory exceptions"
as defined in §38-30-113(5)(a), C.R.S., then the Buyer or Seller must provide the deed or written instructions for preparation of the
deed to the Closing Company for closing. For any Buyer or Seller provided deed or written instructions for preparation of the deed
that requires a list of exceptions other than the "statutory exceptions,"the Buyer and Seller will hold the Closing Company harmless
for any causes of action arising out of the use of such deed. The parties acknowledge that the real estate broker working with either
the Buyer or Seller is not responsible for reviewing or approving any deed not prepared by the real estate broker.
4.2. Bill of Sale. If the transaction includes the sale of personal property (i.e. within the Contract or a Personal Property
Agreement) from the Seller to the Buyer, Seller and Buyer authorize Closing Company to prepare the bill of sale conveying the
personal property from the Seller to the Buyer as their scrivener. The Buyer and Seller understand that the bill of sale is a legal
document,and it is recommended that it be reviewed and approved by their respective attorneys.
4.3. Closing Statement. Closing Company will prepare and deliver accurate, complete and detailed closing statements
to Buyer, Seller and the real estate brokers working with Buyer and Seller. Closing Statements will be prepared in accordance with
the Contract and written instructions from the Buyer, Seller, lender or real estate brokers so long as such written instructions are not
contrary to the Contract. If the written instructions are contrary to the Contract,the Buyer and Seller must execute an Agreement to
Amend/Extend Contract.
5. CLOSING FEE. Closing Company will receive a fee of$600.00 for providing closing and settlement services(Closing Fee).
6. RELEASE,DISBURSEMENT. Closing Company is not authorized to release any signed documents or things of value prior
to receipt and disbursement of Good Funds,except as provided in §§ 10, 11 and 12.
7. DISBURSER. Closing Company must disburse all fiords, including real estate commissions, except those funds as may be
separately disclosed in writing to Buyer and Seller by Closing Company or Buyer's lender on or before closing. All parties agree that
no one other than the disburser can assure that payoff of loans and other disbursements will actually be made.
8. SELLER'S NE)' PROCEEDS. Seller will receive the net proceeds of closing as indicated: 0 Cashier's Check, at
Seller's expense Funds Electronically Transferred (wire transfer) to an account specified by Seller, at Seller's expense
❑ Closing Company's trust account check.
9. WIRE AND OTHER FRAUDS. Caution: Wire and other frauds are a significant risk in real estate transactions. Anytime
Buyer or Seller is supplying confidential information, such as social security numbers and bank account numbers, or transferring or
receiving funds,Buyer and Seller should provide the information in person or in another secure manner. Wire instructions should only
be sent by the Closing Company to the Buyer or Seller via encrypted e-mails or encrypted web portals that require end-user
authentication (i.e., password protected). If encrypted e-mails or encrypted web portals are not available, wire instructions should be
delivered by hand,telephone,mail,or overnight courier.Buyers and Sellers should never reply to an e-mail or call a telephone number
included in an e-mail regarding wire instructions or trust changes to wiring instructions received via email without verbal confirmation
from a trusted source. To protect against fraud, money should never be wired based on email instructions alone, and wire transfer
details and payment instructions should always be verified in person or by telephone using a trusted and independently verified
contact number.
Financial Crimes Enforcement Network (FinCEN) Anti-Money Laundering Notice for Residential Real Estate Transfers:
FinCEN is an agency of the US Treasury Department and the primary enforcement agency for combating money laundering pursuant
CL8 CLOSING INSTRUCTIONS Page 1 of 3
to the Bank Secrecy Act.Parties agree to cooperate with the Closing Company to provide all requested documents and information to
meet the Closing Company's requirements for FinCEN reporting.Parties understand that failure to provide documents and information
may result in a delay or failure to close.
10. FAILURE OF CLOSING. If closing or disbursement does not occur on or before Closing Date as set forth in the Contract,
Closing Company, except as otherwise provided herein, is authorized and agrees to return all documents, monies and things of value
to the depositing party, upon which Closing Company will be relieved from any further duty, responsibility or liability in connection
with these Closing Instructions. In addition, any promissory note, deed of trust or other evidence of indebtedness signed by Buyer will
be voided by Closing Company,with the originals returned to Buyer and a copy to Buyer's lender.
11. RETURN OF EARNEST MONEY. Except as otherwise provided in §12 (Earnest Money Dispute), if the Earnest Money is
being held by Closing Company and has not already been returned following receipt of a Notice to Terminate or other written notice
of termination, Closing Company must release the Earnest Money as directed by written mutual instructions from the Buyer and the
Seller. Such release of Earnest Money must be made within five days of Closing Company's receipt of the written mutual instructions
signed by both Buyer and Seller,provided the Earnest Money check has cleared.
12. EARNEST MONEY DISPUTE. In the event of any controversy regarding Earnest Money that is being held by Closing
Company (notwithstanding any termination of the Contract), Closing Company is not required to take any action. In no event shall
Closing Company be required to return Earnest Money deposits to Buyer until funds deposited are verified, credited to the Closing
Company escrow or trust account, and available for immediate withdrawal as a matter of right. Closing Company, at its option and
sole subjective discretion, may: (1) await any proceeding, (2) interplead all parties and deposit Earnest Money into a court of
competent jurisdiction and recover court costs and reasonable attorney and legal fees, or (3) provide notice to Buyer and Seller that
unless Closing Company receives a copy of a Summons and Complaint or Claim (between Buyer and Seller) containing the case
number of the lawsuit (Lawsuit) within one hundred twenty days of Closing Company's notice to the parties, Closing Company is
authorized to return the Earnest Money to Buyer. In the event Closing Company does receive a copy of the Lawsuit and has not
interpled the monies at the time of any Order,Closing Company must disburse the Earnest Money pursuant to the Order of the Court.
13. SUBSEQUENT AMENDMENTS. Any amendments to,or termination of,these Closing Instructions must be in writing and
signed by Buyer, Seller and Closing Company.
14. CHANGE IN OWNERSHIP OF WATER WELL. Within sixty days after closing, Closing Company will submit any
required Change in Ownership form or registration of existing well form to the Division of Water Resources in the Department of
Natural Resources (Division),with as much information as is available. Closing Company is not liable for delaying closing to ensure
Buyer completes any required form.
15. FIRPTA AND COLORADO WITHHOLDING.
15.1. FIRPTA. Seller agrees to cooperate with Buyer and Closing Company to provide any reasonably requested
documents to determine Seller's foreign person status. If withholding is required, Seller authorizes Closing Company to withhold any
required amount from Seller's proceeds and remit it to the Internal Revenue Service. If withholding from Seller is not required,
Closing Company agrees to provide Buyer an executed Affidavit compliant with FIRPTA attesting to that.
15.2. Colorado Withholding. Seller agrees to cooperate with Closing Company to provide any reasonably requested
documents to determine Seller's status. If withholding is required under Colorado law,Seller authorizes Closing Company to withhold
any required amount from Seller's proceeds and remit it to the Colorado Department of Revenue.
16. ADDITIONAL PROVISIONS. The following additional provisions have not been approved by the Colorado Real
Estate Commission:
17. COUNTERPARTS. This document may be executed by each party, separately, and when each party has executed a copy,
such copies taken together are deemed to be a full and complete contract between the parties.
18. BROKER'S COPIES. Closing Company must provide, to each real estate broker in this transaction, copies of all signed
documents that such real estate brokers are required to maintain pursuant to the rules of the Colorado Real Estate Commission.
Closing Company is authorized by both Buyer and Seller to deliver their respective Closing Statement to one or both real estate
broker(s)involved in the transaction.
19. NOTICE,DELIVERY,AND CHOICE OF LAW.
19.1. Physical Delivery and Notice. Any document,or notice to another party must be in writing, except as provided in
§19.2 and §19.3 and is effective when physically received by such party.
19.2. Electronic Notice. As an alternative to physical delivery, any notice may be delivered in electronic form to another
party at the electronic address of the recipient by facsimile,email or I 1.
19.3. Electronic Delivery. Electronic Delivery of documents may be delivered by: (1) email at the email address of the
recipient, (2)a link or access to a website or server, provided the recipient receives the information necessary to access the documents
or(3)facsimile at the facsimile number(Fax No.)of the recipient.
19.4. Choice of Law. These Closing Instructions and all disputes arising hereunder are governed by and construed in
accordance with the laws of the State of Colorado that would be applicable to Colorado residents who sign a contract in Colorado for
real property located in Colorado.
BUYER(S)ACKNOWLEDGE RECEIPT OF THESE CLOSING INSTRUCTIONS.
County of Weld, Colorado, by and through the Board of
County Commissioners of the county of Weld
By:
Scott K. James, Chairman, Board of County
Commissioners of Weld County
CL8 CLOSING INSTRUCTIONS Page 2 of 3
SELLER(S)ACKNOWLEDGE RECEIPT OF THESE CLOSING INSTRUCTIONS.
High Plains Medical LLC, a Colorado limited liability
company
By.
r. er . Sho in as President and
ember/Manager
Date: February 26,2026
CLOSING COMPANY ACKNOWLEDGES RECEIPT OF THESE CLOSING INSTRUCTIONS.
Closing Company's Name: Ste art,i le Company
At . • ed Si:. •turiry Title Date
Address: 2015 Clubhouse D r#20 , reeley,CO 80634
Phone No.: (970)356-5573
Fax No.:
Email Address:
CL8 CLOSING INSTRUCTIONS Page 3 of 3
Stewart Title Company
Compliance Agreement
Purchaser: County of Weld, Colorado, by and through the Board of County Commissioners of the County of
Weld
Seller: High Plains Medical LLC, a Colorado limited liability company
File No.: 2848781
Property Address: 914 11th Avenue, Greeley, CO 80631
Legal: The South 50 feet of Lots 14, 15 and 16, Block 66, CITY OF GREELEY, County of Weld, State of
Colorado.
It is expressly agreed and understood between the undersigned parties that Stewart Title Company is acting as Closing
Agent in the above referenced transaction and shall in no way be liable as to the accuracy or completeness of any Payoff
Statement and/or Assumption Statement that has been provided to said Company for the purposes of closing this
transaction.
I/we understand that Stewart Title Company has no influence on the payoff amounts set forth, as these amounts are
communicated to Stewart Title Company by the creditor(s). I/we understand and acknowledge that Stewart Title Company
will receive a written payoff from the creditor(s)that may be greater than the payoff received by Stewart Title Company as
of the date of closing. I/we understand that if the updated written payoff is greater than the initial payoff received by
Stewart Title Company as of the date of closing, my/our net proceeds received from this loan (if any) may decrease
depending on the updated written payoff. I/we understand and acknowledge that I/we may be required to provide
additional payment outside of closing and made payable to Stewart Title Company in the event that the net proceeds
received from this loan will not compensate for the increase in the amount due on the updated written payoff.
I/we understand and acknowledge that I/we may be held liable for the failure to provide any additional payment to Stewart
Title Company in the event that the net proceeds received from this loan will not compensate for any increase in the
amount due on the updated written payoff. Given the information as set forth in this Compliance Agreement, I/we choose
to close this loan today and will not hold Stewart Title Company responsible for any changes in the payoff amounts or any
additional interest accrued prior to disbursements.
Borrower affirms that he/she/they have not applied or received any forbearance or any deferment of mortgage payments
due to any government program that was created in response to the current market conditions/climate. Borrower
understands that Stewart Title Company is relying on this information and attestation in conjunction with any payoff
statement received by lender. Should the information prove to be inaccurate and a deferment/forbearance was given and
not accounted for, Borrower understands that it is solely his/her/her responsibility to reimburse or provide said deferred
funds to Stewart Title Company.
Stewart Title Company has acted in good faith in compiling the data and information as set forth on the applicable
Settlement Statement(s). The undersigned agree that any additional funds due and payable after closing will be
immediately paid by the responsible party (s).
The undersigned hereby authorizes (Escrow Branch Revenue)to release copies of closing documents (including but not
limited to the purchase and sale contract and amendments or addendums thereto, documents obtained in satisfaction of
title commitment requirements, real estate and loan closing documents)to lenders, mortgage brokers, real estate agents
and attorneys involved in the transaction. The Company is not authorized to release any documents that contain financial
information (e.g., credit report, loan application), or the Purchaser's taxpayer identification number to real estate agents.
The Company may retain copies of all closing documents signed by the Purchaser and all documents and/or information
collected from the Purchaser in connection with the transaction.
The undersigned further agree that in the event any of the documents required in this closing misstate or inaccurately
reflect the true and correct terms and provisions thereof, and said misstatement or inaccuracy is due to a unilateral
mistake on the part of Stewart Title Company mutual mistake on the part of the undersigned and Stewart Title
Company or clerical error, then in such event the undersigned shall upon request by Stewart Title Company and in
order to correct such misstatement or inaccuracy, execute such new documents or initial such corrected original
documents as Stewart Title Company may deem necessary to remedy said inaccuracy or mistake. The undersigned
further agrees that, in addition to any other filed fees, for any checks re-issued 6 months after the original issue date or on
File No.: 2848781 Page 1 of 2
any amounts escheated to the State, the Title Company will assess a$25 check handling fee. This fee will be assessed at
the time of escheat or re-issue of the funds, as applicable.
IN WITNESS WHEREOF, the party (s) has/have executed this Agreement this 26th day of February, 2026.
County of Weld, Colorado, by and through the Board of High Plains Medical LLC, a Colorado limited liability
County Commissioners of the county of Weld company
By:
By: C op er J. Shovlin a President and
Sco K. James, Chairman, Board of County Member/Manager
Commissioners of Weld County
File No.: 2848781 Page 2 of 2
STATEMENT OF AUTHORITY
(38-30-172, C.R.S.)
1. This Statement of Authority relates to an entity named High Plains Medical LLC, a Colorado limited liability
company
And is executed on behalf of the entity pursuant to the provisions of
Section 38-30-172 C.R.S.
2. The type of entity is a A Colorado limited liability company
3. The mailing address for the entity is:
PO BOX 1809
Greeley, CO 80632
4. The entity is formed under the laws of Colorado
5. The name of the person(s) authorized to execute instruments conveying, encumbering, or otherwise
affecting title to real property on behalf of the entity is:
Christopher J Shovlin as President and Member/Manager
6. The authority of the foregoing person(s) to bind the entity is E1 Not limited OR ❑ Limited as follows:
7. Other matters concerning the manner in which the entity deals with interest in real property:
Dated this (Z4LL. day of( 1e ,• (,(9(r
O
High Plains Medical LLC, a Colorado limited liability company
C /// J. ovlin, Presid nt and Member/Manager
State of Colorado
County of Weld
The foregoing instrument was acknowledged before me this 26th day of February, 2026 by Christopher J.
Sho lin a President and Member/Manager of High Plains Medical LLC, a Colorado limited liability company.
`\ r c: `f r
u lic LISA JOAN E STEVENS
Notary' ` � /�7
My Commiss. xpir . 10007 NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 19954016931
MY COMMISSION EXPIRES OCTOBER 24,2027
File No.: 2848781 Page 1 of 1
Statement of Authority Seller Full CO
SPECIAL WARRANTY DEED State Doc Fee: $83.50
Recording Fee: $43.00
THIS DEED is dated the 26th day of February, 2026, and is made between
(whether one, or more than one),
High Plains Medical LLC, a Colorado limited liability company
the "Grantor" of the County of and State of Colorado and
County of Weld, Colorado, by and t gh the Board of County Commissioners of the County of Weld
initial initial
In Severalty, (whether one, or more than one), the "Grantee", whose legal address is 914 11th Avenue, Greeley,
CO 80631 of the County of and State of Colorado.
WITNESS,that the Grantor, for and in consideration of the sum of Eight Hundred Thirty Five Thousand
Dollars and No Cents ($835,000.00), the receipt and sufficiency of which is hereby acknowledged, hereby
grants, bargains, sells, conveys and confirms unto the Grantee and the Grantee's heirs and assigns forever, all
the real property, together with any improvements thereon, located in the County of Weld
and State of Colorado described as follows:
The South 50 feet of Lots 14, 15 and 16, Block 66, CITY OF GREELEY, County of Weld, State of Colorado.
also known by street address as: 914 11th Avenue, Greeley, CO 80631
Reserving unto the Grantor any and all Oil, Gas, Gravel, Minerals and Mineral rights underlying and appurtenant
to the property described above.
TOGETHER with all and singular the hereditaments and appurtenances thereto belonging, or in anywise
appertaining, the reversions, remainders, rents, issues and profits thereof, and all the estate, right, title, interest,
claim and demand whatsoever of the Grantor, either in law or equity, of, in and to the above bargained premises,
with the hereditaments and appurtenances;
TO HAVE AND TO HOLD the said premises above bargained and described, with the appurtenances, unto
the Grantee, and the Grantee's heirs and assigns forever. The Grantor, for the Grantor and the Grantor's heirs
and assigns, does covenant, grant, bargain, and agree that the Grantor shall and will WARRANT THE TITLE
AND DEFEND the above described premises, in the quiet and peaceable possession of the Grantee and the
heirs and assigns of the Grantee, against all and every person or persons claiming the whole or any part thereof,
by, through, or under the Grantor except and subject to: Statutory Exceptions as defined in C.R.S. § 38-30-
113(5)(a).
IN WITNESS WHEREOF, the Grantor has executed this deed on the date set forth above.
High Plains Medical LLC, a Colorado limited liability
company
By:
Chr r ho in as President and
M be Manager
State of Colorado
County of Weld
The foregoing instrument was acknowledged before me this 26th day of February, 2026 by Christopher J.
Shovlin a President and Member/Manager of High Plains Medical LLC, a Colorado limited liability company.
-ve 1,i
/
NQt y ° blic: LIMN Sevens
LISA JOAN E S T EVOIS
My Commission Expires: 0 ober 24, 2027 NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 19954016931
MY COMMISSION EXPIRES OCTOBER 24,2027
Stewart Title File No.: 2848781 Page 1 of 1
Statutory Special Warranty Deed CO
TD-1000
Confidential Document
This form provides essential market information to the county assessor to ensure accurate,fair and
uniform assessments of all property. This document is not recorded,is kept confidential, and is not
available for public inspection.
This declaration must be completed and signed by either the grantor(seller) or grantee(buyer).
Questions 1, 2, 3, and 4 may be completed(prefilled) by a third party, such as a title company or closing
agent,familiar with details of the transaction. The signatory should confirm accuracy before signing.
This form is required when conveyance documents, subject to a documentary fee, are presented for
recording. If this form is not completed and submitted,the county assessor may send notice. If the
completed and signed form is not returned to the assessor within 30 days of notice,the assessor may
impose a penalty of$25.00 or 0.025% (0.00025) of the sale price, whichever is greater.
Additional information as to the purpose, requirements,and level of confidentiality regarding this form
are outlined in Colorado Revised Statutes, sections 39-14-102, 39-5-121.5, and 39-13-102.
1. Physical Address and/or legal description of the real property sold: Please do not use P.O.Box numbers.
The South 50 feet of Lots 14, 15 and 16, Block 66, CITY OF GREELEY, County of Weld, State of Colorado.
914 11th Avenue,Greeley,CO 80631
2. Type of property purchased: E Single Family Residential E Townhome ❑ Condominium ❑ Multi-Unit Residential
lZ Commercial ❑ Industrial El Agricultural El Mixed Use ❑ Vacant Land El Other
3. 2/26/2026 1/27/2026
Date of Closing: mm/dd/yyyy Date of contract mm/dd/yyyy
4. $835,000.00
Total Sale Price: include all real and personal property Contracted price(if different from final sale price)
5. List any personal property included in the transaction that materially impacts the total sales price.
Personal property may include,but is not limited to,machinery or equipment,vehicles,exceptional appliances,electronic
devices,furniture,or anything that would not typically transfer with the real property(attach additional pages if necessary).
Description Approximate Value
•
Personal Property Total: $
If no personal property is listed,the entire purchase price will be assumed to be for the real property.
6. Did the total sale price include a trade or exchange of additional real or personal property? ®No 0 Yes
If Yes,approximate value of the goods or services as of the date of closing: $
If Yes,does this transaction involve a trade under IRS Code Section 1031? El No ❑ Yes
7. Was 100%interest in the real property purchased? O No ®Yes
Mark"No"if only a partial interest is being purchased. If No, interest purchased
8. Is this a transaction between related parties or acquaintances?This includes persons connected by blood or marriage,or
business affiliates,or those acquainted prior to the transaction. 0 No 0 Yes
9. Please mark type of sale: ❑Builder(new construction) ❑ Public(MLS or Broker Representation)
❑ Private(For Sale by Owner) ® Other(describe)
10. Mark any of the following that apply to the condition of the improvements at the time of purchase.
❑ New ❑ Excellent ❑ Good ❑ Average ❑ Fair ❑ Poor ❑ Salvage
11. Type of financing: (Mark all that apply)
❑ None(all cash or cash equivalent)
❑ New/Mortgage Lender(government-backed or conventional bank loan)
❑ New/Private Third Party(nonconventional lender,e.g.,relative,friend,or acquaintance)
❑ Seller(buyer obtained a mortgage directly from the seller)
❑ Assumed(buyer assumed an existing mortgage)
❑ Combination or Other:Please explain
12 Total amount financed
13. Terms:
❑ Variable; Starting interest rate % ❑ Fixed;Interest rate
Length of time years
Balloon payment? ❑ No ❑ Yes If yes,amount $ Due date
14. Mark any that apply: ❑ Seller assisted down payments ❑ Seller concessions ❑ Special terms or financing
If marked,please specify terms:
15. Was.an independent appraisal obtained in conjunction with this transaction? 0 No 0 Yes
For properties OTHER THAN Residential(Residential is defined as:single family detached,townhomes,apartments and
condominiums),please complete questions 16—18,if applicable.
16. Did the purchase price include a franchise or license fee? ❑No ❑ Yes
If yes,franchise or license fee value $
17. Did the purchase price involve an installment land contract? ❑No ❑ Yes •
If yes,date of contract
18. If this is vacant land,was an on-site inspection conducted by the buyer prior to the closing? ❑No ❑ Yes
Please include any additional information concerning the transaction and price paid that you feel is important.
2/26/2026 County of Weld,Colorado,by and through
the Board of County Commissioners of the
County of Weld
Signature of Grantee(Buyer) Date mm/dd/yyyy Printed name of Grantee
2/26/2026
Signature of Grantee(Buyer) Date mm/dd/yyyy Printed name of Grantee
Buyer Mailing Address:Future correspondence(tax bills,property valuations, etc.)regarding this property should be mailed to:
1150 O St Greeley,CO 80631
Address(mailing) City State Zip Code
bocc-contracts@weld.gov
weld.gov
Daytime Phone Email Address
Contact information is kept confidential,for County Assessor and Treasurer use only,to contact buyer with questions regarding
this form,property valuation,or property tax information.
INDEMNITY AND AFFIDAVIT
AS TO DEBTS, LIENS, AND POSSESSION
To be filled in personally by Seller in his/her own handwriting.
File No.: 2848781
Real Property and improvements located in the County of Weld, State of Colorado, and more particularly described as follows:
GR 5049 S50 L14 THRU 16 BLK66
914 11th Avenue, Greeley, CO 80631
Before me, the undersigned authority on this day personally appeared
High Plains Medical LLC, a Colorado limited liability company
Seller(s)*
personally known to me to be the person(s) whose name is subscribed hereto and upon his/her oath deposes and says that no
proceedings in bankruptcy or receivership have been instituted by or against him/her and that the marital status of Affiant has not
changed since the day of acquisition of said property and represents to the purchaser and/or Lender in this transaction that there are:
1. No unpaid debts for lighting and plumbing fixtures, water heaters, floor furnaces, heaters, air conditioners, built-in fireplace
screens, installed outdoor cooling equipment, swimming pool equipment, built-in cleaning equipment, built-in kitchen equipment,
satellite dish, radio or television antennae, garage door openers, carpeting, rugs, lawn sprinkling systems, venetian blinds, curtains and
rods, window shades, draperies and rods, valances, screens, shutters, awnings, mirrors, ceiling fans, attic fans, mail boxes, security
and fire alarm detection equipment, water softener, electric appliances, fences, street paving, or any personal property or fixtures that
are located on the subject property described above, and that no such items have been purchased on time payment contracts, and
there are no security interests on such property secured by financing statement, security agreement or otherwise except the following:
Creditor Approximate Amount
(If NONE,write"NONE"on blank line) •
2. No loans, unpaid judgments, or liens (including Federal or State Liens or Judgment Liens) and no unpaid governmental or
association taxes, charges or assessments of any kind on such property except the following:
Creditor , ` Approximate Amount
LV Zit-1
(If NONE,write"NONE"on blank line)
3. All labor and material used in the construction of improvements on the above described property have been paid for and there
are now no unpaid labor or material claims against the improvements or the property upon which same are situated, and I hereby
declare that all sums of money due for the construction of '
improve ents have been fully paid and satisfied, except the following:
improvements
(If NONE,write"NONE"on blank line)
4. No leases, contracts to sell the land, or parties in possession other an Affiant except as follows:
(If NONE,write"NONE"on blank line)
If any deed of trust recorded against my property secures an open line of credit or a revolving line of credit, I/we affirm that I/we have
not drawn additional funds from the line of credit since the date of the Payoff Statement from my/our lender to Stewart Title Company.
I/we further agree and affirm that I/we will not make any further draws on the line of credit after the date of this affidavit. I/we further
affirm that I/we have not taken out any loans against our property other than those shown on the above referenced commitment
number. I/We.further agree that said account will be closed.
Indemnity: I agree to pay on demand to the purchasers and/or lender and/or title companies (including Stewart Title Guaranty
Company) in this transaction, their successors and assigns, all amounts secured by any and all liens, claims or rights not show above,
together with all costs, loss and attorney's fees that said parties may incur in connection with such unmentioned liens, provided said
liens, claims, or rights either currently apply to such property, or a part thereof, or are subsequently established against said property
and are created by me, known by me, or have an inception or attachment date prior to the closing of this transaction and recording of
the deed and deed of trust.
I realize that the Purchaser and/or Lender and Title Companies in this transaction are relying on the representations contained herein in
purchasing same or lending money thereon and issuing title policies and would not purchase same or lend money or issue a title policy
thereon unless said representations were made. If Seller or Borrower is an entity, I have authority to sign on its behalf.
High Plains Medical LLC, a Colorado limited liability
company
By:
Shovli as Pres' ent and
tuber/Manager
State of Colorado
County of Weld •
Subscribed and sworn to before me on this 26th day of February, 2026 by Christopher J. Shovlin as President and
Membe /M ger of High Plains Medical LLC, a Colorado limited liability company.
;L2• oe aP- -----
N tar I : LISA JOAi' NE STEVENS
/
MyCommissio .fires la(1`/47 NOTARY PUBLIC
STATE OF COLORADO
NOTARY ID 19954016931
MY COMMISSION EXPIRES OCTOBER 24,2027
File No: 2848781 Page 1 of 1
FINAL LIEN AFFIDAVIT AND AGREEMENT
Date: February 26, 2026
Property: Real property and improvements located in the County of Weld, State of CO, and more particularly described
as follows:
GR 5049 S50 L14 THRU 16 BLK66
914 11th Avenue, Greeley, CO 80631
File No.: 2848781
PURCHASER'S AFFIDAVIT:
The undersigned, Purchaser(s) of the herein described property, to induce Stewart Title Guaranty Company to issue its
ALTA LOAN or ALTA OWNERS Policies of Title Insurance, without including therein an exception as to mechanics' liens
or other statutory liens, in connection with the property described in said commitment, or any rights thereto, where no
notice of such liens or rights appear of record, do hereby make the following representations to Stewart Title Guaranty
Company with full knowledge and intent that said company shall rely thereon:
1. That the improvements on the real estate herein described have been fully completed and have been accepted by the
undersigned as completed and as satisfactory.
2. The full purchase price has been paid by said purchaser(s)to said Owner/Seller.
3. The said premises (were) (will be) occupied by said purchaser(s) on or about d C76 r94P
4. That the undersigned are not aware of any bills for services, labor or materials used in connection with the
construction of the improvements located on said property which have not been paid.
5. That the undersigned have not caused any materials to be furnished or work to be done on the improvements located
on said property or said property itself, which could give rise to any mechanics' or other statutory liens, claims and/or liens
for such material or work, have not executed any security agreements or financing statements for materials, appliances,
fixtures or furnishings, placed upon the property herein described or installed in the improvements located on said
property.
6. In light of the foregoing facts, the undersigned, in connection of the issuance by Stewart Title Guaranty Company of a
policy of Title Insurance covering said property in the manner described by the undersigned as set out above, hereby
promise, covenant and agree to hold harmless, protect and indemnify Stewart Title Guaranty Company, the Mortgagee
and their successors in interest from and against those liabilities, losses, damage, expenses and charges, including but
not limited to attorney's fees and expenses of litigation by reason of any mechanics' or other statutory liens claims and/or
liens for services, labor or materials used in connection with the construction of improvements located on said property
insofar as they pertain to Paragraphs 1 to 5 above.
County of Weld, Colorado, by and through the Board of
County Commissioners of the county of Weld
By:
co James, Chairman, Board of County
Commissioners of Weld County
State of Colorado
County of Weld
Subscribed and sworn to before me on this 26th day of February, 2026 by Scott K. James as Chairman, Board of County
Commissioners of Weld County of County of Weld, Colorado, by and through the Board of County Commissioners of the
County of
N tar lic: (� / ILISA JOANNE STEVENS
My Commission xpire • lok9t ri NOTARY PUBLIC
STATE OF CO!ORADO
NOTARY ID '19954016931
MY COMMISSION EXPIRES OCTOBER 24,2027
File No.:2848781 Page 1 of 1
Final Lien Affidavit and Agreement CO
Stewart Title Company
stewart art 2015 Clubhouse Dr#203
V Greeley,CO 80634
TITLE (970)356-5573 main
Joanne.Stevens@stewart.com
REAL ESTATE TAX, WATER, SEWER, HOA, PROPANE & SEPTIC AGREEMENT
Date: February 26, 2026 File No.: 2848781
Property: 914 11th Avenue, Greeley, CO 80631
I. TAXES: The basis of the tax proration is as follows:
❑X The previous year's taxes in the amount of$11568.40
❑ An estimate of taxes for the current year: $
❑ Local Assessed Value: $ ❑ School Assessed value: $
❑ Local Mill Levy ❑ School Mill Levy
❑ Total assessed value: $
❑ Mill Levy
❑ Total Estimated Taxes: $
❑ Other
❑ Tax Exemption Applies
SUCH PRORATION SHALL BE CONSIDERED A FINAL SETTLEMENT UNLESS OTHERWISE AGREED IN WRITING
BY BUYER AND SELLER. IF THE PRORATION IS NOT FINAL SETTLEMENT, THE BUYER(S)AND SELLER(S)
HEREBY AGREE THAT THEY ASSUME FULL RESPONSIBILITY FOR PURSUING AND EFFECTING THE
ADJUSTMENT,AND STEWART TITLE COMPANY SHALL HAVE NO RESPONSIBILITY IN REGARD THERETO.
The above figures were obtained by telephone from the County Treasurer's and/or Assessor's office. Stewart Title
Company is released from any and all liability in the event the County misquoted the assessment and/or mill levy figures.
Any further adjustments shall be made solely between the Buyer(s) and Seller(s), if necessary, and will not make or be
responsible for this re-adjustment or any liability connection therewith.
Stewart Title Company assumes no responsibility for pursuing and effectuating any readjustments and is released from
any and all responsibility for said readjustments.
Stewart Title Company assumes no responsibility for the adjustment of special assessments, taxes, or for the exception of
said items in the conveyance, unless they are shown on the County Treasurer's Certificate of Taxes Due. Seller(s)
hereby warrants that special assessments affecting subject property, including but not limited to Homeowner's Association
dues or assessments, are paid in full, except as reflected on the statement of settlement.
II. WATER/SEWER:
PER INFORMATION FROM: City of Greeley
❑ No Proration
❑ Flat Rate items for Sewer/Wastewater/Storm Water in the amount of$f 1 have been prorated between buyer and
seller for the billing period of: f 1
l Escrow Agent has withheld $800.00 from the seller's proceeds to pay the final billing for any water and/or sewer
charges. Funds withheld in excess of the amount due on the final statement shall be returned to the seller. In the event
the final bill exceeds the escrowed amount, any additional charges are the responsibility of the seller and/or buyer.
❑ Escrow Agent has withheld $f 1 from the seller's proceeds to pay the final billing for any water and/or sewer
charges to be sent directly to [ 1 Water Company for escrow to be refunded directly from them.
File No.: 2848781 Page 1 of 3
❑ Escrow Agent has not prorated for water and sewer.Any adjustments required will be made between buyer(s) and
seller(s) and are not a part of the closing.
❑ Water/Sewer included in HOA.
III. HOMEOWNER'S/CONDOMINIUM ASSOCIATION:
The property is subject to ONE Homeowner/Condominium Association.
❑X Not Applicable
❑ The homeowner's or condominium association has provided verbal or written information to the Escrow Agent, and
has indicated that for the current assessable period, the assessment ❑ has ❑ has not been paid. The assessment ❑
has ❑ has not been prorated between the buyer(s) and seller(s). If applicable, any working capital/transfer fees/
statement fees have also been collected per the HOA statement and purchase contract.
**By signing below, seller certifies that there are no notices of special assessment or HOA violations from any of the HOA
companies associated with this property to date other than those listed, if any, on the status letter(s) received by the HOA
company(s).
Both parties agree that any special assessments OR violations not listed on the status letter(s)will be handled outside of
this closing transaction by the parties and both sellers and purchasers agree to indemnify Stewart Title Company of any
loss due to non-disclosure of same.
IV. PROPANE:
❑X N/A
❑ Has been paid in the amount of$1 I. Prorated at$J land J l gallons
V. SEPTIC
D N/A
❑ Seller and Buyer agree to hold harmless and indemnify Stewart Title Company of any fines,fees, damages, attorney
fees and/or court costs as a result of failure to comply with the"On-site Waste Water Treatment System Transfer of Title
Inspections".
County of Weld, Colorado, by and through the Board of
County Commissioners of the county of Weld
By: ___/----
Sc tt K. James, Chairman, Board of County
Commissioners of Weld County
File No.: 2848781 Page 2 of 3
High Plains Medical LLC, a Colorado limited liability
company
By:
Chr' o r . vlin as President and
mb /Manager
File No.: 2848781 Page 3 of 3
•
City Of G� ��
Colorado
ree e
Great.From the Ground Up.
Utility Billing Department Title Co.: Stewart Title Company
utility.billing@greeleygov.com Contact Name: Joanne Stevens
Phone: (970) 350-9811 Email: Joanne.Stevens@stewart.com
Phone:
Service Address: 914 11th Avenue, Greeley, CO 80631 Account#: [
TRANSFER OF OWNERSHIP
The information collected by the City of Greeley(i.e. phone numbers and email addresses)will be used exclusively for City
purposes and will never be sold or provided to anyone outside of our organization.
Seller Information
Printed Name(s): High Plains Medical LLC 33 .-3 ) 10
Forwarding Address: PO PX\t i gihzc% ,E\1 e.D M.p6L Phone: (970) 33-2=3464
Signature(s):
Buyer Information
Printed Name(s): County of Weld, State of Colorado
Mailing Address: 914 l lth Avenue Phone:
Greeley, CO 80631 Email: bocc-
contracts@weld.gov
Number of people. 'ving at the home*
Signature(s):
* Greeley uses a Water Budget as a way to bill customers for their water use. Your Water Budget depends on the number of
people living in the house. We use this information for water budget purposes.if it changes,just let us know. Learn more at
EfficienceRewarded.com and sign up for Greeley.WaterSmart.com to get a good picture of your water use.
***FORM NOT VALID WITHOUT CLOSERS SIGNATURE***
As a representative of the Title Company listed above, I certify that the driver's license/I.D. number(s)
and identity of the buyer(s) have been verified by our office. I understand that completed document
must be emailed immediately after closing, and that services will not be transferred to buyer until this
completed d Cu' nt is received by the City of Greeley.
Signatre: {� �� •I,e. Title: Escrow Officer
Printed Name: Ste j Date: c1 a(od(n
Finance-Financial Services * 1000 10`h Street,Greeley, CO 80631 * (970) 350-9731
We promise to preserve and improve the quality of life for Greeley through timely,courteous and cost-effective service.
File No.: 2848781 Page 1 of 1
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