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Home My WebLink About20141683.tiff RESOLUTION RE: ACTION OF THE BOARD CONCERNING PETITION FOR ABATEMENT OR REFUND OF TAXES - SAFEWAY, INC. (9 PARCELS) WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board of County Commissioners of Weld County, State of Colorado, at a duly and lawfully called regular meeting held on the 9th day of June, 2014, at which meeting there were present the following members: Acting Chair Pro-tem Mike Freeman, and Commissioners Sean P. Conway, and William F. Garcia, with Commissioners Doug Rademacher and Barbara Kirkmeyer excused. WHEREAS, notice of such meeting and an opportunity to be present has been given to the taxpayer and the Assessor of said County, with said Assessor, Christopher Woodruff, being present, and taxpayer, Safeway, Inc., not being present, and WHEREAS, the Board of County Commissioners has carefully considered the attached petitions for 9 parcels, and is fully advised in relation thereto. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Board concurs with the recommendation of the Assessor and the petition be and hereby is, denied. CORRECTION PARCEL TO ASSESSED ABATEMENT TAX NUMBER VALUATION OR REFUND YEAR P0004635 $0.00 $0.00 2011/2012 P2408703 $0.00 $0.00 2011/2012 P1809301 $0.00 $0.00 2011/2012 P1962001 $0.00 $0.00 2011/2012 P2027402 $0.00 $0.00 2011/2012 P2722504 $0.00 $0.00 2011/2012 P3012005 $0.00 $0.00 2011/2012 P0004634 $0.00 $0.00 2011/2012 P2027302 $0.00 $0.00 2011/2012 CC: ASRCSw,DK! 2014-1683 AS0087 TAX ABATEMENT PETITION - SAFEWAY, INC. (9 PARCELS) PAGE 2 The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 9th day of June, A.D., 2014. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST:Wairow ��,,// L EXCUSED /o�� Douglas Rademacher, Chair Weld County Clerk to the Board EXCUSED Barbara Kirkmeyer, Pro-Tem D y Clerk to the Board Sean P. Conway APP: : V. . AS : �/ �.� Mike Fre= a ting Chair Pro-Tem ounty Attorney �tf th% ham F. Garcia Date of signature: 7'8- 14 ` te.44.4,b"11O) fRie QyNi : 2014-1683 AS0087 AASSESSMENT December 23, 2013 121 interpark btvd.,ste.308 san antonio,texas 78216 p\210.222.1221 f\210.222.9519 Weld CO County Assessor atechltd.com PO Box 758 Greeley, CO 80632 RECEUED Re: Filing of 2011 and 2012 Petition for Abatement ZD�3 DEC 3 WELD COUNfl AbsESSOR GREELEY, COLCyD0 Dear Sir or Madam, Enclosed please a 2011 and 2012 Petition for Abatement for each of the accounts listed below. Should you have any question, please do not hesitate to contact our office at (210)222-1221 or by email at safewayf&atechltd.com n Owner Name County Schedule or Parcel Number Property Address Ore M Safeway Weld CO P0004635 1122 Av. Greeley �v 0 Safeway Weld CO P2408703 1300 Dexter St. Fort Lupton We o m cn Safeway Weld CO P1809301 1535 Main St. O `o Oc o C Safeway Weld CO P1962001 1535 Main St. mZ m Safeway Weld CO P2027402 8134 14 Cr. RD �� C Safeway Weld CO P2722504 4548 Centerplace Dr. Safeway Weld CO P3012005 4632 Centerplace Dr. Safeway Weld CO P0004634 3526 W. 10 St. Safeway Weld CO P2027302 8206 13 Cr. RD Respectfully submitted, Teresa N. Jerry Senior Client Services Representative Enclosure: as stated 2014-1683 PETITION FOR ABATEMENT OR REFUND OF TAXES i D/ - �� • r ' County: Weld CO Date Received (Use Assessor's or Commissioners'Date Stamp) Section I: Petitioner,please complete Section I only. Date: 12/23/2013 Month Day Year Petitioner's Name: Safeway Inc Petitioner's Mailing Address: 1371 OAKLAND BLVD 200 WALNUT CREEK CA 94596 City or Town State Zip Code SCHEDULE OR PARCEL NUMBER(S) PROPERTY ADDRESS OR LEGAL DESCRIPTION OF PROPERTY P2027302 8206 13 Cr.RD Petitioner requests an abatement or refund of the appropriate taxes and states that the taxes assessed against the above property for property tax year(s) 2011 and 2012 are incorrect fo ns 4 tgfl,. (name been levied erroneously or illegally,whether due toFER pp art Ip. Vkrvaluation. Attach additional sheets if necessary.) Property not assessed at fair market value-including adjustments for obsolescence MAY 0 9 2014 DEC 31 2013 WELD COUNTY WELD GRFELD Criij i i w;; f LEY. c�,L, wL, ; a Petitioner's estimate of value: $39,422 (2011 )and $39,700 (2012 ) Value Year Value Year I declare,under penalty of perjury in the second degree,that this petition,together with any accompanying exhibits or statements,has been prepared or examined by me,and to the best of my knowledge,information and belief, is true,correct,and complete. Daytime Phone Number( ) CIPetitio'e's Slg`7ature By AAA 2 Daytime Phone Number f 2 I0)rr�� 2 - Z t27 I Agent's signature* *Letter of agency must be attached when petition is submitted by an agent. If the Board of County Commissioners,pursuant to§39-10-114(1),C.R.S.,or the Property Tax Administrator,pursuant to§39-2-116,C.R.S., denies the petition for refund or abatement of taxes in whole or in part,the Petitioner may appeal to the Board of Assessment Appeals pursuant to the provisions of§39-2-125,C.R.S.,within thirty days of the entry of any such decision,§39-10-114.5(1),C.R.S. Section II: Assessor's Recommendation (For Assessor's Use Only) Tax Vear 2D Tax Year I I2°1 2 Actual Assessed Tax Actual Assessed Tax originall it ! IS≤S ' 1 z6�l S SS o dli a 7l6.q tr $gggj IC( �L 2S178.6 $ 7 q Dcf, 5-1 Corrected��__SS I, 2U1JO0 -Y '27I0, Il,1 141X1 1121,780 lig loci•OI Abate/Refund C7) '( 1111 l 7 0 Assessor recommends approval as outlined above. If the request for abatement is based upon the grounds of overvaluation,no abatement or refund of taxes shall be made if an objection or protest to such valuation has been tiled and a Notice of Determination has been mailed to the taxpayer,§39-10-114(1)(a)(I)(D),C.R.S. Tax year: Protest? 0 No ❑Yes (If a protest was filed,please attach a copy of the NOD.) Tax year: Protest? ❑No 0 Yes (If a protest was filed,please attach a copy of the NOD.) Assessor recommends denial for the following reason(s): Valui_Ql �rre t(,6 or ,-� h pio - ot oft-) ��,) 21orsDersature 1 / 15-DPT-AR No.920-66/11 FOR ASSESSORS AND COUNTY COMMISSIONERS USE ONLY { (Section III or Section IV must be completed) r ' Every petition for abatement or refund filed pursuant to §39-10-114,C.R.S.shall be acted upon pursuant to the provisions of this section by the Board of County Commissioners or the Assessor,as appropriate,within six months of the date of tiling such petition,§39-1-113(1.7),C.R.S. Section III: Written Mutual Agreement of Assessor and Petitioner (Only for abatements up to$10,000) The Commissioners of County authorize the Assessor by Resolution No. to review petitions for abatement or refund and to settle by written mutual agreement any such petition for abatement or refund in an amount of$10,000 or less per tract,parcel,or lot of land or per schedule of personal property, in accordance with§39-1-113(1.5),C.R.S. The Assessor and Petitioner mutually agree to the values and tax abatement/refund of: Tax Year Tax Year Actual Assessed Tax Actual Assessed Tax Original Corrected Abate/Refund Note:The total tax amount does not include accrued interest,penalties,and fees associated with late and/or delinquent tax payments,if applicable. Please contact the County Treasurer for full payment information. Petitioner's Signature Date Assessor's or Deputy Assessor's Signature Date Section IV: Decision of the County Commissioners (Must be completed if Section III does not apply) WHEREAS,the County Commissioners of County,State of Colorado,at a duly and lawfully called regular meeting held on / / ,at which meeting there were present the following members: Month Day Year with notice of such meeting and an opportunity to be present having been given to the Petitioner and the Assessor of said County and Assessor (being present--not present)and Name Petitioner (being present—not present),and WHEREAS,the said Name County Commissioners have carefully considered the within petition,and are fully advised in relation thereto, NOW BE IT RESOLVED,that the Board(agrees--does not agree)with the recommendation of the Assessor and the petition be(approved--approved in part—denied)with an abatement/refund as follows: Year Assessed Value Taxes Abate/Refund Year Assessed Value Taxes Abate/Refund Chairperson of the Board of County Commissioners'Signature County Clerk and Ex-officio Clerk of the Board of County Commissioners in and for the aforementioned county,do hereby certify that the above and foregoing order is truly copied from the record of the proceedings of the Board of County Commissioners. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of said County this day of Month Year County Clerk's or Deputy County Clerk's Signature Note: Abatements greater than$10,000 per schedule,per year,must be submitted in duplicate to the Property Tax Administrator for review. Section V: Action of the Property Tax Administrator (For all abatementsgreater than $10,000) The action of the Board of County Commissioners,relative to this abatement petition,is hereby ❑Approved O Approved in part$ O Denied for the following reason(s): Secretary's Signature Property Tax Administrator's Signature Date 15-DPT-AR No.920-66/11 SAFEWAY 0 • May 17, 2013 RE: Appointment of Agent Safeway,Inc. To Whom It May Concern: Please be advised that the firm of Assessment Technologies, Ltd., ("ATLTD")has been retained and granted power of attorney to represent the interests of the entity Safeway,Inc,,with respect to all property tax issues and matters regarding all business personal property accounts with your office. Communications related to the appeals process should be mailed to; Assessment Technologies,Ltd. 121 lnternark,Suite 308 San Antonio, TX 78216' Attn:Safeway,Inc.Account Manager I Please continue to send Tax bills and Assessment Notices to the owner on record. Thank you for your assistance in this matter. If you should have any questions or concerns please contact Teresa Jerry,Account Manager at(210)403-4436 or by email at tjerry@atechltd.com. Sincerely, Donn Matsuza 1 Asst.Tax Manager County of Contra Costa Ss State of California I hereby acknowledge that the foregoing is true and correct and that I am authorized by Safeway,Inc.to engage said aget t. 1, 1� � � _�__. _ Dorm MatsazA1 f Subscrred d sworn to this_day of August,2013 by Donn Matsuzaki, a person known to me. CHED L\ 1 11,; Notary ub c (with seal if used in that state) SEE Al.RNI� RYIFI ATE nIRII\ CE Ju-Tat • State of California • • Contra Costa • County of • • Subscribed and sworn to (or affirmed)bbe�fore'me on this f< • day of /kVOli�3�{ • 20 I2, by POVir) I" A/7-(4 J proved to me on the basis of satisfactory evidence to be the person%who appeared before me. /j CAITLYN RAE TANKERSLEY j 1 2te,�/ �`� / �IIY'.; Commission al1959074 �a Notary Public-California Sigma e (Nolan,seal) 2•y 114,;17•14,0 Contra Costa County a M Comm.Ex fires Nov 3,2015 • OPTIONAL INFORMATION • • INSTRUCTIONS POR COMPLETING THIS FORM . The wording of all Jura completed to California after January 7,2008 must • be in lheforn as set forth within this Jurat.There are no exceptions,1a Jurat to be completed does not follow this form, the notary must correct the verbiage by wing afwn stamp containing the correct wording or attaching a • separatetwat form such as this one which does contain proper wording. In DESCRIPTION OF TTY ATTACHED DOCUMENT addition,the norary must require an oath or emotion from the document y�r,h (�.� �- / (( signer regarding the trutirfudness of the conferrer of the document. The C f�) f { V 1. All 1,�) kilt' document must be signed AMMSR the oath or agimulon.;the doevment was frittlee..ppr r descriptionof •attached document)✓• prevlovrly signed,it cwt be rcatemedin front of the notary public during the • `1 _ Gi t4 i 11,16 *taprooms. • (Title or description of attached document continued) • State and County information must be the State and County where the document signee(s)prsonally appeared before the notarypublla Number of Pages •l Document Date • Date of notarization must be the date that the signers)personally appeared which must also bo the same date thejuratprocess is completed • hint the name(s)of document signer(s)who pea-mildly appear at the time of notarization. (Additional information) • Signature of the notary public mast match the signature on file with the office of the county clerk. • 'Ito notary seal impression must be clear and photographically reproducible. • -. impression must not cover text or lines.If seal impression smudges,rased if a sufficient area permits,otherwise complete a different just loan. .• Additional information is not required but cputd help to ensure this ' . Juror is not misused or attached Indifferent different document. . • Indicate title or type of attacheddocument,number of pages and data. • Securely attach this document to the signed document • • 2008 Version CAM v1,9.07 800-873-9865 www.NotatyClasses.com PETITION FOR ABATEMENT OR REFUND OF TAXES 4 9o/3-dill/ County: Weld CO Date Received (Use Assessor's or Commissioners'Date Stamp) Section I: Petitioner,please complete Section I only. • Date: 12/23/2013 Month Day Year Petitioner's Name: Safeway Inc Petitioner's Mailing Address: 1371 OAKLAND BLVD 200 WALNUT CREEK CA 94596 City or Town State Zip Code SCHEDULE OR PARCEL NUMBER(S) PROPERTY ADDRESS OR LEGAL DESCRIPTION OF PROPERTY P0004634 3526 W. 10 St. Petitioner requests an abatement or refund of the appropriate taxes and states that the taxes assessed against the above property for property tax year(s) 2011 and 2012 are incorrect for the following e : iefly describe why the taxes have been levied erroneously or illegally,whether 6srvalu irr arity in levying,clerical error or overvaluation. Attach additional sheets if necessa �(Fe�.,@�g rf Property r gespr tviEjet value-including adjustments for obs �fiCe"'" DEC MAY O92014 312013 WELD COLIC i . r\.,..±. OR WELD COUNTY GREELEY. COLCADO PetitioneChM1�E'RS S 645,998 (_2011 )and $580,047 (2012 ) Value Year Value Year I declare,under penalty of perjury in the second degree,that this petition,together with any accompanying exhibits or statements,has been prepared or examined by me,and to the best of my knowledge, information and belief, is true,correct,and complete. Daytime Phone Number j ) By CAG1 Petition sSignnalre 7 LLA i' T�'�1dnW' " Daytime Phone Number j 7 It) 72 z I 2_2- ) Agent's Signature' 'Letter of agency must be attached when petition is submitted by an agent. If the Board of County Commissioners,pursuant to§39-10-114(1),C.R.S.,or the Property Tax Administrator,pursuant to§39-2-116,C.R.S.. denies the petition for refund or abatement of taxes in whole or in part,the Petitioner may appeal to the Board of Assessment Appeals pursuant to the provisions of 9 39-2-125,C.R.S.,within thirty days of the entry of any such decision,§39-10-114.5(1),C.R.S. Section II: Assessor's Recommendation ll (For Assessor's Use Only) Tax Year T0 I I Tax Year _Dice. ,�{ Actual Assessed Tax Actual As d Tax Origins,,, j, ionlgIiis— it0 35( 0 �L18.5(0.Kg411451IOCgft(1926jr&o 13c3:2 83' u7 Corrected I, it 14( q 1, `11 1(D K 3.S/ S 3 851 c,M 1 t t 4',�Vyl/U 6 W H ?O J"k) '^ 2,H, (D Abate/Refund y5 ,P _ 7 P ❑Assessor recommends approval as outlined above. !! If the request for abatement is based upon the grounds of overvaluation,no abatement or refund of taxes shall be made if an objection or protest to such valuation has been filed and a Notice of Determination has been mailed to the taxpayer,§39-10-114(1)(a)(I)(D),C.R.S. Tax year: Protest? O No ❑Yes (If a protest was filed,please attach a copy of the NOD.) Tax year: Protest? ❑No ❑Yes (If a protest was flied,please attach a copy of the NOD.) Assessor recommends denial for the following reason(s): \lQ\tkcj coYrnr h1 C cc o u 2j t-3 Fr s A VD0L uv-0 . sagas s Dep Ass sots g afore 15-DPT-AR No.920-66/11 C/ FOR ASSESSORS AND COUNTY COMMISSIONERS USE ONLY (Section III or Section IV must be completed) 4-1 Every petition for abatement or refund filed pursuant to §39-10-114,C.R.S.shall be acted upon pursuant to the provisions of this section by the Board of County Commissioners or the Assessor,as appropriate,within six months of the date of fling such petition,§39-1-113(17),C.R.S. Section III: Written Mutual Agreement of Assessor and Petitioner (Only for abatements up to$10,000) The Commissioners of County authorize the Assessor by Resolution No. to review petitions for abatement or refund and to settle by written mutual agreement any such petition for abatement or refund in an amount of$10,000 or less per tract, parcel,or lot of land or per schedule of personal property,in accordance with§39-1-113(1.5),C.R.S. The Assessor and Petitioner mutually agree to the values and tax abatement/refund of: Tax Year Tax Year Actual Assessed Tax Actual Assessed Tax Original Corrected Abate/Refund Note:The total tax amount does not include accrued interest,penalties,and fees associated with late and/or delinquent tax payments,if applicable. Please contact the County Treasurer for full payment information. Petitioner's Signature Date Assessor's or Deputy Assessor's Signature Date Section IV: Decision of the County Commissioners (Must be completed if Section III does not apply) WHEREAS,the County Commissioners of County,State of Colorado,at a duly and lawfully called regular meeting held on / / ,at which meeting there were present the following members: Month Day Year with notice of such meeting and an opportunity to be present having been given to the Petitioner and the Assessor of said County and Assessor (being present—not present)and Name Petitioner (being present—not present),and WHEREAS,the said Name County Commissioners have carefully considered the within petition,and are fully advised in relation thereto, NOW BE IT RESOLVED,that the Board(agrees--does not agree)with the recommendation of the Assessor and the petition be(approved--approved in part—denied)with an abatement/refund as follows: Year Assessed Value Taxes Abate/Refund Year Assessed Value Taxes Abate/Refund Chairperson of the Board of County Commissioners'Signature County Clerk and Ex-officio Clerk of the Board of County Commissioners in and for the aforementioned county,do hereby certify that the above and foregoing order is truly copied from the record of the proceedings of the Board of County Commissioners. IN WITNESS WHEREOF,I have hereunto set my hand and affixed the seal of said County this day of Month Year County Clerk's or Deputy County Clerk's Signature Note: Abatements greater than$10,000 per schedule,per year,must be submitted in duplicate lo the Property Tax Administrator for review. Section V: Action of the Property Tax Administrator (For all abatements greater than$10,000) The action of the Board of County Commissioners,relative to this abatement petition,is hereby ❑Approved O Approved in part$ O Denied for the following reason(s): Secretary's Signature Property Tax Administrator's Signature Date 15-OPT-AR No.920-66/11 • SAFEWAYO, May 17, 2013 RE: Appointment of Agent Safeway,Inc. To Whom It May Concern: Please be advised that the firm of Assessment Technologies, Ltd., ("ATLTD")has been retained and granted power of attorney to represent the interests of the entity Safeway,Inc.with respect to all property tax issues and matters regarding all business personal property accounts with your office. Communications related to the appeals process should be mailed to: Assessment Tech nologies,Ltd. 121 Inter park,Suite 308 San Antonio, TX 78216' • Attn:Safeway,Inc.Account Manager Please continue to send Tax bills and Assessment Notices to the owner on record. Thank you for your assistance in this matter. If you should have any questions or concerns please contact Teresa Jerry, Account Manager at(210)403-4436 or by email at Gerry@atechltd.com. Sincerely, 'd' Donn Matsuza i Asst.Tax Manager County of Contra Costa Ss State of California I hereby acknowledge that the foregoing is true and correct and that I am authorized by Safeway,Inc.to engage said ages t. Donn Matsaz/aki Subscrl ed¢nd sworn to this_day of August,2013 by Donn Matsuzaki,a person known to me. h GHED t<- .1IF ' Notary Idle (with seal if used in that state) ATTP `' SC I IFGcZMP TM ATE �ni\g1PL CER • • t , • Jurat • State of California • Contra Costa • County of • Subscribed and sworn to (or affirmed)before= on this -1 day of l viti�-- 20 1. by 1)01/11/1M(t 1.4/7-(4 �--( J� proved to me on the basis of satisfactory evidence to be the personycwho appeared before me. • • • CAITLYN RAE TANKERSLEY 0) ,(7 1� �eA !> Commission N 19590 •�Jy 11!!: t`a Notary Public•CallforSins a oar :a Contra Costa CountyMCommETresNov3,2015E Y- --- a - -- - - - • • • • OPTIONAL INFORMATION • • INSTRUCTIONS FOR COMPLETING THIS FORM . The wording of ail✓rvals completed in Calffomla afro Amery 1,2008 must • be in the form as set forth Within this forest There moo exceptions.fa fatal to be completed does not follow this form, the notary must corned the verbiage by using a faro!stamp containing the correct wording or attacMng a • SeparateJured form such as this one which does contain proper wording In DESCRIPTION OF THE ATTACHED DOCUMENT addition,the notary must require an oath or affirmation from the document }2vbit , �;} '{��V p�{{!� signer regarding the lmtlfitiness of the contents of the document. The ril i Y t.1/.{ � �f'{ f `'/[-' ' I'I' document most be signed AP-TMthe oath or efnation. fthe dowanen!was 1 l(7itle-pr description of attached document)J. prcvtovsty,rlgnad,It must be re-signed In front of the notary public during the furetproeen. (Title or desoription of attached document continued) • State and County information must be the State and County wham the document sigaer(s)personally appearedbefore the notarypubaa Number of Pages •I Document Date ▪ Date of notarization the zetion must be the data that algmiaow*(smiaow*appeared. which must also be the same date the)matprocess is completed • • Print the name(s)of document signer®who pantie •appear at the time of notarization. (Additional reformation) • Signature of the notary public most match the signature on file with the office of the county clerk. • lie notary zeal impression must be clear and pbotographicalfr reproduolble, • -. impression mast not cover text or lines.If seal impression smudges,re-seal if a sufficient area permits,otherwise complete a difthrust Jurat loan. G Additional information is not required but could help to ensure this • Juratis not misused or attached to a different document . Indicate title or type of attached document number of pages and data • Securely attach this document to the signed document • • 2008 Version CAPA v1.9.07 800-873-9865 www.NotaryClasses.com PETITION FOR ABATEMENT OR REFUND OF TAXES County: Weld CO Date Received C91)0-DDS (Use Assessor's or Commissioners'Date Stamp) Section I: Petitioner, please complete Section I only. Date: 12/23/2013 Month Day Year Petitioner's Name: Safeway Inc Petitioner's Mailing Address: 1371 OAKLAND BLVD 200 WALNUT CREEK CA 94596 City or Town State Zip Code SCHEDULE OR PARCEL NUMBER(S) PROPERTY ADDRESS OR LEGAL DESCRIPTION OF PROPERTY P3012005 4632 Centerpiece Dr. Petitioner requests an abatement or refund of the appropriate taxes and states that the taxes assessed against the above property for property tax year(s) 2011 and 2012 are incur Weir $,s efly describe why the taxes have been levied erroneously or illegally,whetheru tr u rl in levying,clerical en-ti vQryfrly�`tipptgy?ch additional sheets if necessa3 :Am Property not assr�ss''3S352211 a r e -including adjustments for obsolescence MAY 0 9 2014 DEG • • M31 2013 WELD COUN'E Y AS. ESSOR WELD COUNTY GREELEY. COLORADO COMMISSIONERS Petitioner's estimate of value: $102,276 (2011 )and $90,293 (2012 ) Value Year Value Year I declare,under penalty of perjury in the second degree,that this petition,together with any accompanying exhibits or statements, has been prepared or examined by me,and to the best of my knowledge, information and belief,is true,correct,and complete. Daytime Phone Number{ ) /I 4 Petitioner' Signature By I ,l-A /.AA . Daytime Phone Number j 2-1l� `� 2Gz I az I Agent's Signature' `Letter of agency must be attached when petition is submitted by an agent. If the Board of County Commissioners,pursuant to§39-10-114(1),C.R.S.,or the Property Tax Administrator,pursuant top 39-2-116,C.R.S., denies the petition for refund or abatement of taxes in whole or in pan,the Petitioner may appeal to the Board of Assessment Appeals pursuant to the provisions of§39-2-125,C.R.S.,within thirty days of the entry of any such decision,§39-10-114.5(1),C.R.S. Section II: Assessor's Recommendation (For Assessor's Use Only) �T Tax YearD I Tax Year) {')'7 Actual Assessed Tax Actual Assessed Tax Original 142S5(t i lk74I I� *51�1io.$)--- ilaWS;73z °Sigle6 S1O S 3O Corrected . 1 aC5 &V-\s --p4i rst $5j l lc.`()-4 c) ' 1 - 61 glob 5i Si Di&x 3o Abate/Refuntl / 9( O Assessor recommends approval as outlined above. If the request for abatement is based upon the grounds of overvaluation,no abatement or refund of taxes shall be made if an objection or protest to such valuation has been filed and a Notice of Determination has been mailed to the taxpayer,§39-10-114(1)(a)(I)(D),C.R.S. Tax year: Protest? 0 No ❑Yes (If a protest was filed,please attach a copy of the NOD.) Ta(x year: Protest? ❑No 0 Yes (If a protest was filed,please attach a copy of the NOD.) )ii.Assessor recommends denial for the following reason(s): .J 6e-01 pkOCL0Lvel-O . Assessor's Deputy Assessor's n lure 15-DPT-AR No.920-66/11 • a FOR ASSESSORS AND COUNTY COMMISSIONERS USE ONLY (Section III or Section IV must be completed) Every petition for abatement or refund filed pursuant to §39-10-114,C.R.S.shall be acted upon pursuant to the provisions of this section by the Board of County Commissioners or the Assessor,as appropriate,within six months of the date of filing such petition,§39-1-113(1.7),C.R.S. Section III: Written Mutual Agreement of Assessor and Petitioner (Only for abatements up to$10,000) The Commissioners of County authorize the Assessor by Resolution No. to review petitions for abatement or refund and to settle by written mutual agreement any such petition for abatement or refund in an amount of$10,000 or less per tract, parcel,or lot of land or per schedule of personal property, in accordance with§39-1-113(1.5),C.R.S. The Assessor and Petitioner mutually agree to the values and tax abatementrefund of: 'Tax Year Tax Year Actual Assessed Tax Actual Assessed Tax Original Corrected Abate/Refund Note:The total tax amount does not include accrued interest,penalties,and fees associated with late and/or delinquent tax payments.if applicable. Please contact the County Treasurer for full payment information. • Petitioner's Signature Date Assessor's or Deputy Assessor's Signature Date Section IV: Decision of the County Commissioners (Must be completed if Section III does not apply) WHEREAS,the County Commissioners of County,State of Colorado,at a duly and lawfully called regular meeting held on / / ,at which meeting there were present the following members: Month Day Year with notice of such meeting and an opportunity to be present having been given to the Petitioner and the Assessor of said County and Assessor (being present--not present)and Name Petitioner (being present—not present),and WHEREAS,the said Name County Commissioners have carefully considered the within petition,and are fully advised in relation thereto, NOW BE IT RESOLVED,that the Board(agrees--does not agree)with the recommendation of the Assessor and the petition be(approved—approved in part—denied)with an abatement/refund as follows: Year Assessed Value Taxes Abate/Refund Year Assessed Value Taxes Abate/Refund Chairperson of the Board of County Commissioners'Signature I, County Clerk and Ex-officio Clerk of the Board of County Commissioners in and for the aforementioned county,do hereby certify that the above and foregoing order is truly copied from the record of the proceedings of the Board of County Commissioners. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of said County this day of Month Year County Clerk's or Deputy County Clerk's Signature Note: Abatements greater than$10,000 per schedule,per year.must be submitted in duplicate to the Property Tax Administrator for review. Section V: Action of the Property Tax Administrator (For all abatements greater than$10,000) The action of the Board of County Commissioners,relative to this abatement petition, is hereby ❑Approved ❑Approved in part$ ❑Denied for the following reason(s): Secretary's Signature Property Tax Administrator's Signature Date 15-DPT-AR No.920-66/11 • SAFEWAY0• May 17, 2013 RE: Appointment of Agent Safeway,Inc. To Whom It May Concern: Please be advised that the firm of Assessment Technologies, Ltd., ("ATLTD")has been retained and granted power of attorney to represent the interests of the entity Safeway,Inc. with respect to all property tax issues and matters regarding all business personal property accounts with your office. Communications related to the appeals process should be mailed to: Assessment Technologies,Ltd. 1211nterpark,Suite 308 San Antonio, TX 78216' . Ann:Safeway,Inc.Account Manager Please continue to send Tax bills and Assessment Notices to the owner on record. Thank you for your assistance in this matter. If you should have any questions or concerns please contact Teresa Jerry,Account Manager at(210)403-4436 or by email at(jerry@atechltd.com. • Sincerely, td- Donn ____Matsuza i Asst,Tax Manager County of Contra Costa Ss State of California I hereby acknowledge that the foregoing is true and correct and that I am authorized by Safeway,Inc.to engage said I ages t.•16 -116:7"/7 ____..__ Dorm Matsuzalci f Subscri e l d sworn to this_day of August,2013 by Donn Matsuzaki, a person known to me. cFiE.o t✓ kip i_-- Notary ub�lc (with seal if used in that state) SGE FVR IP RTiF� ATE wicf\RIP\ cE . mrat State of California • Contra Costa • County of • • Subscribed and sworn to (or affirmed)before'me on this 4' • day of A1,112-St- 202_2 by • Pal Mgt IA/7-C VH proved to me on the basis of satisfactory evidence to be the person%who appeared before me. • //�' } TA/ �/� CAITLYN RAE TANKERSLEY V 7 s1 I„ ✓✓ I l i .� ,62,.,x' Iii Y'rtY'.�`_ Commission N 1959074 1 1 4 i,,•�• a Notary Public•California Signatt> • (Mc"seal) ` cif Contra Costa County .= M Comm.Ea fires Nov 3,2015[ • • • • OPTIONAL INFORMATION • • • INSTRUCTIONS POR COMPLETING I ES FORM . • The wording of all Jura completed in California after January 1,2008 mnvt be in the form as set forth within thisJurai There are no aceplionr.$a Swat to be completed dots not fallow this form, the notary must correct the verbiage by wing a Jura!stamp containing the correct wording or attaching a • separate Jwat form such as Mir one which does contain proper warding. In DESCRIPTION OF THE ATTACHED DOCUMENT addition,the notary must require on oath or a nndion from the document i�vl t r signer regarding the truthfulness of the contents of the document The LeA l}l 1,/ ) krill—l document must be signed AFTER the oath orafrmctlon.I/the document war (Irtle_pr description of attached document)✓ Previously signed,It must be re-signed fn front of the notary public during the l�4.14-C.Wi I4 tL Jwatproeeaa. • • (Title or description of attached document continued) • State and County information must be the State and County where the f document slgoer(s)personally appe redbefore the notary pane. Number of Pages •1 Document Date Data of nohdution must be the date that the signer(s) pereally appeared which must also be the same date thejurat process is completed • hint the name(s)of document signer(s)who personally appear at the time of uotmfretioo. (Additional information) • Signature of the notary public roust match the signature on Mc with the office of the county etc& • The notary seal impression most be clear and photographically repmdumble. • • . liopression must not cover teat or tines Itseal impression smudges,re-seal if a sufficient area permits,otherwise complete a diifereat jurat form. Additional Information is not requited but could help to ensure this jurat is not misused or attached to a different document • Indicate title or type of attached document,number of pages and data. • Securely attach this document to the signed document • • 2008 Version CAPA v1.9.07 800-873-9865 www.NotaryClasses.com ea. I. i PETITION FOR ABATEMENT OR REFUND OF TAXES //��j�� County: Weld CO Date Received 020/3 -064 (Use Assessor's or Commissioners'Date Stamp) Section I: Petitioner, please complete Section I only. Date: 12/23/2013 Month Day Year Petitioner's Name: Safeway Inc Petitioner's Mailing Address: 1371 OAKLAND BLVD 200 WALNUT CREEK CA 94596 City or Town State Zip Code SCHEDULE OR PARCEL NUMBER(S) PROPERTY ADDRESS OR LEGAL DESCRIPTION OF PROPERTY P2722504 4548 Centerplace Dr. Petitioner requests an abatement or refund of the appropriate taxes and states that the taxes assessed against the above property for property tax year(s) 2011 and 2012 are incorrect for the following reasons: (Briefly describe why the taxes have been levied erroneously or illegally,whether due to erroneous valuation, irregularity in levying,clerical error or overvaluation. Attach additional sheets if necessary.) RECEIVED Property not assessed at fair market value-including adjustments for obsolescence thy- u MAY 0 9 2014 WELD COUNTY WELD COUNTY COMMISSIONERS COMMISSIONERS Petitioner's estimate of value: $647'171 (2011 )and $563,719 (2012 ) Value Year Value Year I declare,under penalty of perjury in the second degree,that this petition,together with any accompanying exhibits or statements, has been prepared or examined by me,and to the best of my knowledge, information and belief, is true,correct,and complete. Daytime Phone Number j ) Petitioner' Signaturre By tiL(A 4—(/U' Daytime Phone Numbers Z R) ZZ z- 12 - Agent's Signature' *Letter of agency must be attached when petition is submitted by an agent. If the Board of County Commissioners,pursuant to§39-10-114(1),C.R.S.,or the Property Tax Administrator,pursuant to§39-2-116,C.R.S., denies the petition for refund or abatement of taxes in whole or in part,the Petitioner may appeal to the Board of Assessment Appeals pursuant to the provisions of)39-2-125,C.R.S.,within thirty days of the entry of any such decision,§39-10-114.5(1),C.R.S. Section II: Assessor's Recommendation n (For Assessor's Use Only) Tax Year 20( 1 Tax Year 26f/2- Actual Assessed Tax Actual Assessed Tax Original ,I l(Le gigA Fth9, 200 13 9j..q.-4(I14'Del/'yor-114n/•70O 1(.31137S, `f1 Corrected I(II7/ 9L8 tit;91 6D A 3Sl ce I.crk((t-t(Y124& '$L1OG17(x1 -Ifa(137 . (fc Abate/Refund 77 27 - CCC cS O Assessor recommends approval as outlined above. If the request for abatement is based upon the grounds of overvaluation,no abatement or refund of taxes shall be made if an objection or protest to such valuation has been filed and a Notice of Determination has been mailed to the taxpayer,§39-10-114(1)(a)(I)(D),C.R.S. Tax year: Protest? ❑No ❑Yes (If a protest was filed,please attach a copy of the NOD.) Tax year: Protest? D No O Yes (If a protest was filed,please attach a copy of the NOD.) Assessor recommends denial for the following reason(s): Vat u l @ nre ti-(-1 ct,z,,_c,ran ''e (1,,rtb"fay p Assessor' or Deputy Assessor's nature 15-DPT-AR No.920-66/11 FOR ASSESSORS AND COUNTY COMMISSIONERS USE ONLY r k (Section III or Section IV must be completed) Every petition for abatement or refund filed pursuant to §39-10-114,C.R.S.shall be acted upon pursuant to the provisions of this section by the Board of County Commissioners or the Assessor,as appropriate,within six months of the date of filing such petition,§39-1-113(1 7),C.R.S. Section III: Written Mutual Agreement of Assessor and Petitioner (Only for abatements up to$10,000) The Commissioners of County authorize the Assessor by Resolution No. to review petitions for abatement or refund and to settle by written mutual agreement any such petition for abatement or refund in an amount of$10,000 or less per tract, parcel,or lot of land or per schedule of personal property,in accordance with§39-1-113(1.5),C.R.S. The Assessor and Petitioner mutually agree to the values and tax abatement/refund of: Tax Year Tax Year A ual Assessed Tax Actual Assessed 3 Original Corrected Abate/Refund Note:The total tax amount does not include accrued interest,penalties,and fees associated with late and/or delinquent tax payments,if applicable. Please contact the County Treasurer for full payment information, Petitioner's Signature Date Assessors or Deputy Assessor's Signature Date Section IV: Decision of the County Commissioners (Must be completed If Section III does not apply) WHEREAS,the County Commissioners of County, State of Colorado,at a duly and lawfully called regular meeting held on / / ,at which meeting there were present the following members: Month Day Year with notice of such meeting and an opportunity to be present having been given to the Petitioner and the Assessor of said County and Assessor (being present—not present)and Name Petitioner (being present—not present),and WHEREAS,the said Name County Commissioners have carefully considered the within petition,and are fully advised in relation thereto, NOW BE IT RESOLVED,that the Board(agrees--does not agree)with the recommendation of the Assessor and the petition be(approved—approved in part—denied)with an abatement/refund as follows: Year Assessed Value Taxes Abate/Refund Year Assessed Value Taxes Abate/Refund Chairperson of the Board of County Commissioners'Signature County Clerk and Ex-officio Clerk of the Board of County Commissioners in and for the aforementioned county,do hereby certify that the above and foregoing order is truly copied from the record of the proceedings of the Board of County Commissioners. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of said County this day of Month Year County Clerk's or Deputy County Clerk's Signature Note: Abatements greater than$10,000 per schedule,per year,must be submitted in duplicate to the Property Tax Administrator for review. Section V: Action of the Property Tax Administrator (For all abatements greater than$10,000) The action of the Board of County Commissioners,relative to this abatement petition, is hereby ❑Approved ❑Approved in part$ O Denied for the following reason(s): Secretary's Signature Property Tax Administrator's Signature Date 15-DPT-AR No.920-66/11 'T A SAFEWAYa May 17, 2013 RE: Appointment of Agent Safeway,Inc. To Whom It May Concern: Please be advised that the firm of Assessment Technologies,Ltd., ("ATLTD")has been retained and granted power of attorney to represent the interests of the entity Safeway,Inc.with respect to all property tax issues and matters regarding all business personal property accounts with your office. Communications related to the appeals process should be mailed to: Assessment Technologies,Ltd. 121 liner park, Suite 308 San Antonio, TX 78216' . Attn:Safeway,Inc.Account Manager Please continue to send Tax bills and Assessment Notices to the owner on record. Thank you for your assistance in this matter. If you should have any questions or concerns please contact Teresa Jerry, Account Manager at(210)403-4436 or by email at(jcrry@atechltd.com. • Siinnc)erely, Donn Matsuza I Asst.Tax Manager County of Contra Costa Ss State of California I hereby acknowledge that the foregoing is true and correct and that I am authorized by Safeway, Inc.to engage said ag . �, , /a / ^ Donn Matsuzaly 44 f Subscrilted d sworn to this_day of August,2013 by Donn Matsuzaki,a person� known to me. GHeD V�l�i �ik Notary ubllc (with seal if used in that state) SSE ATTR to A E hn("fNOP' CERYtF( • , • • Jurat • State of California • • Contra Costa • • County of . • Subscribed and sworn to (or affirmed)beforeme on this ' • day of /kV(l191--- 20 19J by .1)O MC t L1 ? (i proved to me on the basis of satisfactory evidence to be the personf/wbo appeared before me. • • • CAITLYN RAE TANKERSLEY r G A 2t t -`� ,, �Ai , t� Commission 81959074 Notary Public•California Signs 0 (Notarysea0 ` rf 0 Contra Costa County - My Comm.Expires Nov 3.2015 It • , • OPTIONAL INFORMATION • • INSTRUCTIONS FOR COMPLETING TEES FORM . The wording ofall Sw-atr completed to California offer January!,2008 must be hi the form os sel forth within this Jura.There are no exceptions.Va Swat to be completed does not follow this form, the notary must correct the verbiage by loinga fora!stamp containing the cared wording or attaching a •D$5CRIPTION OF TUB ATTACHED DOCUMENT addition, Jurat form such as this one which doer contain proper wording. In addition,the notary must require an oath or emotion from the document Y�- r,f + 1•/ '• ( signer regarding the truthfulness of the contents of the document. The I.)1H { { �. /11� C) .01- document must be signed AFTER the oath or ehmdlon If the document war itt(Tie! .pr description of attached document) PreSur7y signed,ft must be re-signed in front of the notary public during the 414-0 t' /C, ( VII. _ Jurat process. r (Title of description of attached document continued) • State and County infommatien must be the State and County wham the document slgner(s)personally appeared before the nolarypubl o, Number of Pages -I Document Date • Date of notarization must be the data that the signer(s)personally appeared which must also be the same date thejmat process is completed • Print the name(s)of document signer(s)who personalty appear at the time of notarization. (Additional information) • Signature of the notarypubho most match fhe signature on file with the office of the county clerk. • tie notary seld impression must be clear and pbotographicalty reproducible. • . Impression must not cover twat or lines.If seal impression smudges,re-seal if a sufficient area permits,otherwise complete a different jurat form G Addition!intention is not required but cpuld help to ensure this • Jurat is not misused or attached to a different document. . • <• Indicate title or type of attached document,number of pages and data • Securely attach this document to The signed document • • • 2008 Version CAM v1.9.07 800-873-9865 www.NotaryClasses.com } PETITION FOR ABATEMENT OR REFUND OF TAXES • 020/3-067 County: Weld CO Date Received (Use Assessor's or Commissioners'Date Stamp) Section I: Petitioner,please complete Section I only. Date: 12/23/2013 Month Day Year Petitioner's Name: Safeway Inc Petitioner's Mailing Address: 1371 OAKLAND BLVD 200 WALNUT CREEK CA 94596 City or Town State Zip Code SCHEDULE OR PARCEL NUMBER(S) PROPERTY ADDRESS OR LEGAL DESCRIPTION OF PROPERTY P2027402 8134 14 Cr. RD Petitioner requests an abatement or refund of the appropriate taxes and state ax SAP the above property for property tax year(s) 2011 and 2012 are incorre _ ng can ,r describe why the taxes have been levied erroneously or illegally,whether due o erroneous valuation, irregu arity in levying,clerical prp,pr�yept3lltation. Attach additional sheets if necessary.) 1� 2013 Property not asle5lled(bC'fIM�r AI M\ E e-including adjustments for obsolescenceflEC 31 MAY 0 9 20t 'VET . ;,.,� sscik r P .'.E--.,• ✓ COL S. ,.ADO COMMISSIONERS Petitioner's estimate of value: $ 90,090 (2011 )and $352,594 (2012 ) Value Year Value Year I declare,under penalty of perjury in the second degree,that this petition,together with any accompanying exhibits or statements,has been prepared or examined by me,and to the best of my knowledge, information and belief, is true,correct,and complete. Daytime Phone Number( ) Petit ner's�lgggnature By J ` �' Daytime Phone Number j2 ID) 222 ( 22 Agent's Signature` `Letter of agency must be attached when petition is submitted by an agent. If the Board of County Commissioners,pursuant to§39-10-114(1),C.R.S.,or the Property Tax Administrator,pursuant to§39-2-116,C.R.S., denies the petition for refund or abatement of taxes in whole or in part,the Petitioner may appeal to the Board of Assessment Appeals pursuant to the provisions of§39-2-125,C.R.S.,within thirty days of the entry of any such decision,§39-10-114.5(1),C.R.S. Section II: Assessor's Recommendation �a%%�� (For Assessor's Use Only) Tax Year/O( I Tax Year 20f Actual Assessed Tax Actual Assessed Tax Originalil"1lc'22 S 1Z6,21 a-ZD 4'z(p 116(.0tt 48S1(96L IIQSSjb3o IF Z579'1.4D corrected"A °"lo A 262(to 112A(4ob%4K8 II 4&(e $2SSCS( (o& 4 es. -Act. ,0 • Abate/Refund _� e 4- 0 Assessor recommends approval as outlined above. • If the request for abatement is based upon the grounds of overvaluation,no abatement or refund of taxes shall be made if an objection or protest 1 to such valuation has been filed and a Notice of Determination has been mailed to the taxpayer,§39-10-114(1)(a)(I)(D),C.R.S. Tax year: Protest? 0 No ❑Yes (If a protest was filed,please attach a copy of the NOD.) Tax year: Protest? 0 No ❑Yes (If a protest was filed,please attach a copy of the NOD.) Assessor recommends denial for the following reason(s): U Assessor s o eputy Assessor's Sig 15-DPT-AR No.920-66/11 FOR ASSESSORS AND COUNTY COMMISSIONERS USE ONLY ♦ (Section III or Section IV must be completed) ♦ Every petition for abatement or refund filed pursuant to §39-10-114,C.R.S.shall be acted upon pursuant to the provisions of this section by the Board of County Commissioners or the Assessor,as appropriate,within six months of the date of filing such petition,§39-1-113(1.7),C.R.S. Section III: Written Mutual Agreement of Assessor and Petitioner (Only for abatements up to$10,000) The Commissioners of County authorize the Assessor by Resolution No. to review petitions for abatement or refund and to settle by written mutual agreement any such petition for abatement or refund in an amount of$10,000 or less per tract,parcel,or lot of land or per schedule of personal property, in accordance with§39-1-113(1.5),C.R.S. The Assessor and Petitioner mutually agree to the values and tax abatement/refund of: Tax Year Tax Year Actual Assessed Tax Actual Assessed Tax Original Corrected Abate/Refund Note'The total tax amount does not include accrued interest,penalties,and fees associated with late and/or delinquent tax payments,if applicable. Please contact the County Treasurer for full payment information. Petitioner's Signature Date Assessor's or Deputy Assessor's Signature Date Section IV: Decision of the County Commissioners (Must be completed if Section III does not apply) WHEREAS,the County Commissioners of County,State of Colorado,at a duly and lawfully called regular meeting held on / / ,at which meeting there were present the following members: Month Day Year with notice of such meeting and an opportunity to be present having been given to the Petitioner and the Assessor of said County and Assessor (being present--not present)and Name Petitioner (being present—not present),and WHEREAS,the said Name County Commissioners have carefully considered the within petition,and are fully advised in relation thereto, NOW BE IT RESOLVED,that the Board (agrees--does not agree)with the recommendation of the Assessor and the petition be(approved--approved in part—denied)with an abatement/refund as follows: Year Assessed Value Taxes Abate/Refund Year Assessed Value Taxes Abate/Refund Chairperson of the Board of County Commissioners'Signature County Clerk and Ex-officio Clerk of the Board of County Commissioners in and for the aforementioned county,do hereby certify that the above and foregoing order is truly copied from the record of the proceedings of the Board of County Commissioners. IN WITNESS WHEREOF,I have hereunto set my hand and affixed the seal of said County this day of Month Year County Clerk's or Deputy County Clerk's Signature Note: Abatements greater than$10,000 per schedule,per year,must be submitted in duplicate to the Property Tax Administrator for review. Section V: Action of the Property Tax Administrator (For all abatements greater than$10,000) The action of the Board of County Commissioners,relative to this abatement petition,is hereby ❑Approved 0 Approved in part$ 0 Denied for the following reason(s): Secretary's Signature Property Tax Administrator's Signature Date 15-DPT-AR No.920-66/11 • SAFEWAY° May 17,2013 RE: Appointment of Agent Safeway,Inc. To Whom It May Concern: Please be advised that the firm of Assessment Technologies,Ltd., ("ATLTD")has been retained and granted power of attorney to represent the interests of the entity Safeway,Inc. with respect to all property tax issues and matters regarding all business personal property accounts with your office. Communications related to the appeals process should be mailed to: Assessment Technologies,Ltd. 121 haterpark, Strife 308 San Antonio, TX 78216' Attn:Safeway,Inc.Account Manager Please continue to send Tax bills and Assessment Notices to the owner on record. Thank you for your assistance in this matter. If you should have any questions or concerns please contact Teresa Jerry, Account Manager at(210) 403-4436 or by email at(jerryta@ateehltd.com, • Sincerely, Donn Matsuza f Asst.Tax Manager County of Contra Costa Ss State of California I hereby acknowledge that the foregoing is true and correct and that I am authorized by Safeway,Inc.to engage said ages t. ,ADD ._____ Donn Matsuzakki Subscri\ed hi sworn to this—day of August,2013 by Dorm Matsuzaki,a person known to me. CHED t t(6.-1 Notary ub c (with seal if used in that state) SEE�V NIP RT1F, A • • Jiarat • • State of California Contra Costa • County of . Subscribed and sworn to (or affirmed)before'me on this f1 • day of AVM' LiS4 - 201.-Lby .PO Vin `-;'L/7-ci proved to me on the basis of satisfactory evidence to be the person%who appeared before me.• /1 �./"1 . ^�/ / ,/ CAITLYN RAE TANKERSLEY I,' ! 1 "'• -�, �(--�f (GLit, , /� r. !�-��.� Commission v 1959074 a,,,�,��y-- 1a Notary Public•California g Signs a • (Notary seal) 12 -: Contra Costa County :M Comm.Es ires Nov 3,2015 - - Y- - - - a - - - ---• E • • • OPTIONAL INFORMATION • • INSTRUCTIONS FOR COMPLEThNO111IS FORM . • The wording ofali f:antr completed in California after Jemmy J,2008 must be in the form asset forth within thisJmat There are no exceptions.{faiwat to be completed does not follow this form, the notary must corned the verbiage by using affirm stamp contabztng the correct wording or attaching a •D$5tpTTCN OF TUB ATTACHED DOCUMENT separate faro form such alibis one which does contain proper warding In addition, the notary must require an oath or afJbmation from the document r7` ( •i r Q • t_ p signer regarding the trutlfidtees of the contents of the document. The C 1214)Ol-1{ t'� l.241 G..t ) ir? f' document most be signed AFTER the oath or o)9bmdiox.bt the documnawas t(11_tlje(_.,p/rdurrip/tl�on of attached document) previously signed,,It most be re-signedinfront of the notary,public during the ti1 lC NO t l uc fwatproeeu. _ • (Title or description of attached document continued) • State and County information must be the State and County where the f document slgner(s)personally appwedbefore the notary public. Number ofFages •1 Document Date • Date of notarization must be the date that the signer(s)personally appeared which must also be the same date the jurat process is completed. • Pant the name(s)of document signers)who personally appear at the time of notarization. (Additional information) • Signature of the notarypubilo mast match the sigoahure on file with the office of the county clerk. • 11e notary seal impression must be clear and pbotogrsphJca9y npmducible. Impression must not cover teat or lines.If seal impression smudges,re-seal ifs sufficient areapermits,otherwise complete a different Nat form. • Additional infomation is not required but could help to ensure this • Just is not misused or attached to a different document . •� Indicate title or type ofattached document,number of pages and date. • Securely attach this document to the signed document 2008 Version CAPA v1.9.07 800-873-9865 www.NotaryClasses.com " • } , PETITION FOR ABATEMENT OR REFUND OF TAXES County: Weld CO Date Received CRC/3-66y(Use Assessor's or Commissioners'Date Stamp) Section I: Petitioner,please complete Section I only. • Date: 12/23/2013 Month Day Year Petitioner's Name: Safeway Inc Petitioner's Mailing Address: 1371 OAKLAND BLVD 200 WALNUT CREEK CA 94596 City or Town State Zip Code SCHEDULE OR PARCEL NUMBER(S) PROPERTY ADDRESS OR LEGAL DESCRIPTION OF PROPERTY P1962001 1535 Main St. Petitioner requests an abatement or refund of the appropriate taxes and s t s.a se sed a ainst the above property for property tax year(s) 2011 and 2012 are inco r -`I� 1i iefly describe why the taxes have been levied erroneously or illegally,whether t �, I o arity in levying,clerical error or overvaluation. Attach additional sheets if necess - , as Property RE see rvir.�tai Cet value-including adjustments for obsolescence �/ U 'DEC 31 2013 MAY 09 2014 ‘,VELD CUB i< f ,SS±SSOR WELMMD��eC�c+O'�^1U RF.LEv C=OLCYAADO Petitioner's esenlaY�M �s' $41,457 (2011 )and 642,533 (_2012 ) Value Year Value Year I declare,under penalty of perjury in the second degree,that this petition,together with any accompanying exhibits or statements, has been prepared or examined by me,and to the best of my knowledge, information and belief,is true,correct,and complete. 1 Daytime Phone Number Petitioner' Signatu a By ( llit 444/-4/- Daytime Phone Number( Zip) 7 G-7 7 12% Agent's Signature 'Latter of agency must be attached when petition is submitted by an agent. If the Board of County Commissioners,pursuant to§39-10-114(1),C.R.S.,or the Property Tax Administrator,pursuant to*39-2-116,C.R.S., denies the petition for refund or abatement of taxes in whole or in part.the Petitioner may appeal to the Board of Assessment Appeals pursuant to the provisions of)39-2-125,C.R.S.,within thirty days of the entry of any such decision,§39-10-114.5(1),C.R.S. Section II: Assessor's Recommendation • (For Assessor's Use Only) Tax Year•I/I Tax Year as Actual Assessed Tax Actual Assessed Tax 4" Original 103ilev° $ 3cgo.s 1 As o Z9o(0,Y-1 I'll U?oNS(o 5i, c.5- • / 2 corrected I°3( t9U1— q 3q > a .l -i9otfii l f u, 1332 =N 3ofiuo lip?So. t? Abate/Refund Di 17 `7 ❑Assessor recommends approval as outlined above. !!!!!! If the request for abatement is based upon the grounds of overvaluation,no abatement or refund of taxes shall be made if an objection or protest to such valuation has been filed and a Notice of Determination has been mailed to the taxpayer,§39-10-114(1)(a)(l)(D),C.R.S. Tax year: Protest? 0 No ❑Yes (If a protest was filed,please attach a copy of the NOD.) Tax year: Protest? ❑No ID Yes (If a protest was filed,please attach a copy of the NOD.) I `YAssessor recommends denial for the following reason(s): V (au' o_e_eirrLe-i-ll C,.exOac -r-i% ra J _a dwo ,i essors o're• tyAssessor's-'• ature 15-DPT-AR No.920-66/11 r * w FOR ASSESSORS AND COUNTY COMMISSIONERS USE ONLY (Section III or Section IV must be completed) Every petition for abatement or refund filed pursuant to §39-10-114,C.R.S.shall be acted upon pursuant to the provisions of this section by the Board of County Commissioners or the Assessor,as appropriate,within six months of the date of filing such petition,§39-1-113(1.7),C.R.S. Section III: Written Mutual Agreement of Assessor and Petitioner (Only for abatements up to$10,000) The Commissioners of County authorize the Assessor by Resolution No. to review petitions for abatement or refund and to settle by written mutual agreement any such petition for abatement or refund in an amount of$10,000 or less per tract, parcel,or lot of land-or per schedule of personal • property, in accordance with§39-1-113(1.5),C.R.S. • • • The Assessor and Petitioner mutually agree to the values and tax abatement/refund of: Tax Year Tax Year Actual Assessed Tax Actual Assessed Tax Original Corrected Abate/Refund Note:The total tax amount does not include accrued interest,penalties.and fees associated with late and/or delinquent tax payments,if applicable. Please contact the County Treasurer for full payment information. Petitioner's Signature Date Assessors or Deputy Assessor's Signature Date • Section IV: Decision of the County Commissioners • (Must be completed if Section III does not apply) WHEREAS,the County Commissioners of County, State of Colorado,at a duly and lawfully called regular meeting held on / / ,at which meeting there were present the following members: Month Day Year with notice of such meeting and an opportunity to be present having been given to the Petitioner and the Assessor of said County and Assessor (being present--not present)and Name Petitioner (being present—not present),and WHEREAS,the said Name County Commissioners have carefully considered the within petition,and are fully advised in relation thereto, NOW BE IT RESOLVED,that the Board(agrees--does not agree)with the recommendation of the Assessor and the petition be(approved--approved in part—denied)with an abatement/refund as follows: Year Assessed Value Taxes Abate/Refund Year Assessed Value Taxes Abate/Refund Chairperson of the Board of County Commissioners'Signature County Clerk and Ex-officio Clerk of the Board of County Commissioners in and for the aforementioned county,do hereby certify that the above and foregoing order is truly copied from the record of the proceedings of the Board of County Commissioners. IN WITNESS WHEREOF,I have hereunto set my hand and affixed the seal of said County this day of Month Year County Clerk's or Deputy County Clerk's Signature Note: Abatements greater than$10,000 per schedule,per year,must be submitted in duplicate to the Property Tax Administrator for review. Section V: Action of the Property Tax Administrator (For all abatements greater than$10,000) The action of the Board of County Commissioners, relative to this abatement petition, is hereby ❑Approved ❑Approved in part$ O Denied for the following reason(s): Secretary's Signature Property Tax Administrator's Signature Date 15-DPT-AR No.920-66/11 • • SAFEWAYCT May 17, 2013 RE: Appointment of Agent Safeway,Inc, To Whom It May Concern: Please be advised that the firm of Assessment Technologies, Ltd., ("ATLTD")has been retained and granted power of attorney to represent the interests of the entity Safeway,Inc.with respect to all property tax issues and matters regarding alt business personal property accounts with your office. Communications related to the appeals process should be mailed to; Assessment Technologies,Ltd. 121 Interpark,Salle 308 San Antonio, TX 78216' Attn:Safeway,Inc.Account Manager Please continue to send Tax bills and Assessment Notices to the owner on record. Thank you for your assistance in this matter. If you should have any questions or concerns please contact Teresa Jerry, Account Manager at(210)403-4436 or by email at tjerry@atechltd.com. • Sincerely, Donn Matsuza i Asst.Tax Manager County of Contra Costa Ss State of California I hereby acknowledge that the foregoing is true and correct and that I am authorized by Safeway, hie.to engage said ager t. = Dorm Matsuznici f Subscried d sworn to this_day of August,2013 by Donn Matsuzaki,a person known to me. -VACHED L -t \rr Notary ub c (with seal if used in that state) SEE F� RWP, R11F 1 Kit G• CALIF CE • . Jurat • State of California • • Contra Costa ' • County of • • • Subscribed and sworn to (or affirmed)beforee on this /. 1 • day of fkvOU54-- 20_ by 1)0v1r1 \4(y',mi• 4(17-(4 ct j proved to me on the basis of satisfactory evidence to be the personwho appeared before me. 0(�L CAITLYN RAE TANKERSLEY 4 2r V*7 �` ,, �f' I f,/�.�•- ..!*(Yi;,_ CommlasbliM19590ni 11 "(/J �y `�,•-4r- t`a Notary Public•California I SI a 0 (Mtarysm0 Z•' et} Contra Costa County • M Comm.Ez lies Nov 3,2015 • OPTIONAL INFORMATION • • • INSTRUCTIONS POR COMPLETING 11318 FORM • The wording of al JJuair completed in California after January I,2008 mart be In the form asset forth within!hit/drat There arc no exceptions,;la Jurat to be completed does not follow this form, the notary mud correct the verbiage by ruing a Jurat stamp containing the correct wording or attaching a •D�SCRIPTTON OF THE ATTACHED DOCUMENT separate fin-as(orm such aethie one which does contain proper warding. In addition, the notary must require an oath or affirmation from the document rr77// `` (i� (( I signer regarding the truihfuhrees of the contents of the document. The Y 111Vi 1 v i-(r d'�� t�-1 ��,�'f� document must be signed AFTER the oath or a$hmdlon.;the document war .previously signed,it must be re-signed:afloat of the notary during the (Trtia.gr description of attached document) t vie Jwatprooess.(114C 61G1 • (Title or description of attached document continued) • State and County information must be the State and County where the document algner(a)personally appeared before the notarypubtia Number of Pages •1 Document Date • Date of nohdretiou must be the data that the signet)pa son ally appeared which must also be the same date the just process is completed. • Print the name(s)of document signer(s)who personally appear at the time of notrdaAtioa (Additional information) • Signature of the notary publics mast match the signalers on file with the office of the county clerk • • The notary seal impression must be clear and photographically reproducible. • Tiupresslon must not cover teat or lines.If seal impression smudges,re-seal if e sufficient area permits,otherwise complete a different ju at fo®. Additional information is not required but could help to mssno this •• font is not misused or pthahed to a different document. • -' Indicate title or typo of attached document,number ofpages and data • Securely attach this document to the signed document • 2008 Version CAPA v1.9.07 800-873.9865 www.NotaryClasses.com ' PETITION FOR ABATEMENT OR REFUND OF TAXES f County: Weld CO Date Received 00/3-069 (Use Assessor's or Commissioners'Date Stamp) Section I: Petitioner, please complete Section I only. Date: 12/23/2013 Month Day Year Petitioner's Name: Safeway Inc Petitioner's Mailing Address: 1371 OAKLAND BLVD 200 WALNUT CREEK CA 94596 City or Town State Zip Code !i SCHEDULE OR PARCEL NUMBER(S) PROPERTY ADDRESS OR LEGAL DESCRIPTION OF PROPERTY P1809301 1535 Main St. Petitioner requests an abatement or refund of the appropriate taxes and states that the taxes assessed against the above property for property tax year(s) 2011 and 2012 are'vie wing(EaSo . Briety describe why the taxes have been levied erroneously or illegally,wheth On Qk v (t t ularity in levying,clerical error or overvaluation. Attach additional sheets if neces I'.'r, 'N Property not assessed at fair market value-including adjustments for obsolescence PFCs/Ve DEC 31 2013 WELD Ojai N I i AS6LSSOR MAY 00 2px GRFE FY. COLOAADO r4 I Petltl t value: $385,704 (2011 )and $354,719 (2012 ) 4�C IVIMI SUN r 1' Value Year Value Year I declare,under penalty of p f).rrzi in the second degree,that this petition,together with any accompanying exhibits or statements, has been prepared or examined by me,and to the best of my knowledge, information and belief, is true,correct,and complete. 1 Daytime Phone Number] ) Petition's Signatu ye By . /Vli_AL Daytime Phone Number( ZID) 2 2Z I ZZ Agent's Signature' 'Letter of agency must be attached when petition is submitted by an agent. If the Board of County Commissioners,pursuant to§39-10-114(1),C.R.S.,or the Property Tax Administrator,pursuant to§39-2-116,C.R.S., denies the petition for refund or abatement of taxes in whole or in part,the Petitioner may appeal to the Board of Assessment Appeals pursuant to the provisions of§39-2-125,C.R.S.,within thirty days of the entry o1 any such decision,§39-10-114.5(1),C.R.S. Section Il: Assessor's Recommendation go. (For Assessor's Use Only) Tax Year I I Tax Yearf_0 12- Actual Assessed Tax Actual Assessed Tax origlnal1CICoy, Z.tdI 3911,(tta S?7(r4a ti 3 BIPI`1 7 $'7-57,17O .$a(ti law .(n3 Correctedtlfri-li.76 I 12Y)(0`to Sri(*)&I 1f 11(pi f-I g1as7trio J1( (o oo- b3 Abate/Refund V if _.....g_ 9/ 7 0 Assessor recommends approval as outlined above. If the request for abatement is based upon the grounds of overvaluation,no abatement or refund of taxes shall be made if an objection or protest to such valuation has been filed and a Notice of Determination has been mailed to the taxpayer,§39-10-114(1)(a)(l)(D),C.R.S. Tax year: Protest? O No ❑Yes (If a protest was filed,please attach a copy of the NOD.) Taxx year: Protest? ❑No O Yes (If a protest was filed,please attach a copy of the NOD.) (pt Assessor recommends denial for the following reason(s): \VQ.lakket C-0rn x(.� c'AJ f-Unresc f.- 'pvo .J LLc . . -sso or r.puty ssor's ignat e 15-OPT-AR No.920-66/11 PETITION FOR ABATEMENT OR REFUND OF TAXES County: Weld CO Date Received £D/3'D !/� O (Use Assessors or Commissioners'Date Stamp) Section I: Petitioner,please complete Section I only. Date: 12/23/2013 Month Day Year Petitioner's Name: Safeway Inc Petitioner's Mailing Address: 1371 OAKLAND BLVD 200 WALNUT CREEK CA 94596 City or Town State Zip Code SCHEDULE OR PARCEL NUMBER(S) PROPERTY ADDRESS OR LEGAL DESCRIPTION OF PROPERTY P2408703 1300 Dexter St.Fort Lupton Petitioner •4.4 abatement or refund of the appropriate taxes and states that the taxes assessed against the above prop- *IF x ear(s) 2011 and 2012 are incorrect for the following reasons: (Briefly describe why the -x �F�levied erroneously or illegally,whether due to err I rre ularityir�. levying,clerry'IG��eer�rror or ove n. Attach additional sheets if necessary.) 000��aggq -s�aaa + s � � A Property no-t ri es69 aft �r market value-including adjustments for obsolescence�' -�_ '=2 w.. !SSA WELD E ^ llu 4 v�J DEC 31 2013 ERs rdEL LjS OP cPFr+- - r-', rk.zioc Petitioner's estimate of value: $381,270 (2011 )and §334'849 (2012 ) Value Year Value Year I declare, under penalty of perjury in the second degree,that this petition,together with any accompanying exhibits or statements,has been prepared or examined by me,and to the best of my knowledge, information and belief, is true,correct, and complete. Daytime Phone Number j ) / 1 ,, Petition es Signature By I _ ,ct_ /k Daytime Phone Number j l L) 1_7 Z I 22- Agent's Signatu4e' 'Letter of agency must be attached when petition is submitted by an agent. If the Board of County Commissioners,pursuant to§39-10-114(1),C.R.S..or the Property Tax Administrator,pursuant to§39-2-116,C.R.S.. denies the petition for refund or abatement of taxes in whole or in part,the Petitioner may appeal to the Board of Assessment Appeals pursuant to the provisions of§39-2-125,C.R.S,within thirty days of the entry of any such decision.§39-10-114.5(1),C.R.S. Section II: Assessor's Recommendation (For Assessor's Use Only) r� Tax Year V I I Tax Year 93 3 ( 2—"" Actual Assessed Tax Actual Assessed Tax Original -15) 1114 s1(Oi'1 Z,.� �,.)`�i- I. ,A6_I ile7_J -t� {o(i )1� )16>'.;r (('i1 Corrected c J( Ii `B.) ?fF-1lC� >/ jI3:' ( (' . ( J'i t; ) 1, 1�s._; 'jJ.{1 ; I .� D1 I �, (.. . y y Abate/Refund II- �L G (7 . (7-- p El Assessor recommends approval as outlined above. 7 If the request for abatement is based upon the grounds of overvaluation,no abatement or refund of taxes shall be made if an objection or protest to such valuation has been fled and a Notice of Determination has been mailed to the taxpayer,§39-10-114(1)(a)(p(D),C.R.S. Tax year: Protest? O No ❑Yes (If a protest was filed,please attach a copy of the NOD.) Tax year: Protest? ❑No ❑Yes (If a protest was filed,please attach a copy of the NOD.) c2fAssessor recommends denial for the following reason(s): v sessors r eputy sessor's Si ure NV y 15-OPT-AR No.920-66/11 I/' l FOR ASSESSORS AND COUNTY COMMISSIONERS USE ONLY • F (Section III or Section IV must be completed) Every petition for abatement or refund filed pursuant to §39-10-114,C.R.S.shall be acted upon pursuant to the provisions of this section by the Board of County Commissioners or the Assessor,as appropriate,within six months of the date of filing such petition,§39-1-113(1.7),C.R.S. Section III: Written Mutual Agreement of Assessor and Petitioner (Only for abatements up to$10,000) The Commissioners of County authorize the Assessor by Resolution No. to review petitions for abatement or refund and to settle by written mutual agreement any such petition for abatement or refund in an amount of$10,000 or less per tract, parcel,or lot of land or per schedule of personal property, in accordance with§39-1-113(1.5),C.R.S. The Assessor and Petitioner mutually agree to the values and tax abatement/refund of: Tax Year Tax Year Actual Assessed Tax Actual Assessed Tax Original Corrected Abate/Refund Note:The total tax amount does not include accrued interest,penalties,and fees associated with late and/or delinquent tax payments,if applicable. Please contact the County Treasurer for full payment information. Petitioner's Signature Date Assessor's or Deputy Assessor's Signature Date Section IV: Decision of the County Commissioners (Must be completed if Section III does not apply) WHEREAS,the County Commissioners of County,State of Colorado,at a duly and lawfully called regular meeting held on / / ,at which meeting there were present the following members: Month Day Year with notice of such meeting and an opportunity to be present having been given to the Petitioner and the Assessor of said County and Assessor (being present--not present)and Name Petitioner (being present—not present),and WHEREAS,the said Name County Commissioners have carefully considered the within petition,and are fully advised in relation thereto, NOW BE IT RESOLVED,that the Board(agrees--does not agree)with the recommendation of the Assessor and the petition be(approved--approved in part—denied)with an abatement/refund as follows: Year Assessed Value Taxes Abate/Refund Year Assessed Value Taxes Abate/Refund Chairperson of the Board of County Commissioners'Signature County Clerk and Ex-officio Clerk of the Board of County Commissioners in and for the aforementioned county,do hereby certify that the above and foregoing order is truly copied from the record of the proceedings of the Board of County Commissioners. IN WITNESS WHEREOF,I have hereunto set my hand and affixed the seal of said County this day of Month Year County Clerk's or Deputy County Clerk's Signature Note: Abatements greater than$10,000 per schedule,per year,must be submitted in duplicate to the Property Tax Administrator for review. Section V: Action of the Property Tax Administrator (For all abatements greater than$10,000) The action of the Board of County Commissioners,relative to this abatement petition, is hereby ❑Approved O Approved in part$ ❑Denied for the following reason(s): Secretary's Signature Property Tax Administrator's Signature Date 15-OPT-AR No.920-66/11 Y • SAFEWAY(' • May 17,2013 RE: Appointment of Agent Safeway,Inc. To Whom It May Concern: Please be advised that the firm of Assessment Technologies,Ltd.,("ATLTD")has been retained and granted power of attorney to represent the interests of the entity Safeway,Inc. with respect to all property tax issues and matters regarding all business personal property accounts with your office. Communications related to the appeals process should be mailed to: Assessment Technologies,Ltd. 121 Inlerpark,Suite 308 San Antonio, TX 78216' . Ann:Safeway, Inc.Account Manager Please continue to send Tax bills and Assessment Notices to the owner on record. Thank you for your assistance in this matter. If you should have any questions or concerns please contact Teresa Jerry, Account Manager at(210)403-4436 or by email at I]erry@atechltd.com. Sincerely, Si � (4' Donn M_atsuza i Asst.Tax Manager County of Contra Costa Ss State of California I hereby acknowledge that the foregoing is true and correct and that I am authorized by Safeway,Inc.to engage said ages t. to Dorm Matsazth Subscrred d sworn to this_day of August,2013 by Donn Matsuzaki, a person� { known to me. \ > l I -' GHED L. _ t t%` Notary ub c (with seal if used in that state) gEE AT RNIA nA E wit RIAG CERTIFI r • J-urat • State of California • Contra Costa County of . Subscribed and sworn to (or affirmed)before•me on this ' day of i-C 202 by POv1 i �1� h z�1✓��'� -( proved to me on the basis of satisfactory evidence to be the person who appeared before me. • (/}r /, r/^'/ / CAITLYN RAE TANKERSLEY (/ , A ^ rrj (Cfy (L.�i �1 tar l, Commission M 1959074 •v�r m Notary Public-California Signs a • (Notazyseat) 11/4,;2714, Contra Costa County MT Comm.Expires Nov 3,2015 It • • OPTIONAL INFORMATION • • • INSTRUCTIONS FOR COMPLETING MS FORM . • The wording of al Jambs oomphted in California slier January I,2008 must be in thefonn asset forth within this Aral.There are no exceptions.ya/iota/ to be completed does not follow this form, the notary must coned the verbiage by using aJwat stamp containing the coned wording or attaching a • separate Jwat form such aethir one which does contain proper wording. In DESCRIPTION OF THE ATTACHED DOCUMENT additon, the notary must require an oath or affirmation from the document • -�J Ili f�1 t�`/ �`"r p /_ - signer regarding the Irutlfuhta s of the contents of the document. The • l21" t)IY 1I f _ /ill l/ f / .;fir documentmust be signed A07238 the oath or affirmation.i//he doeament was (Title.pr description of attached document).1. •previously signed,it must be re-signed In front of the notary public during the • { wgLl , IOC Jurorprocerr. • (Title or description of attached document continued) • State and County information must be the State and County whew the document signer®personally appearedbefore the notarypubtia. Number ofPages •I Document Date - Date of notarization must be the data that the signer(s)praonally appeared • which must also be the same date the just process is completed. • Print the mame(s)of document-slgner(s)who pasodally appear at the time of nocoizatioa. (Additional information) • Signature of the notary public must match the sigoalre on file with the office of the county cleric. • The notary seat impression must be clear and photographically reproducible. . - . Iivpresslon must not cover tact or lines.If seal impression smudges,re-seal if a sufficient area permits,otherwise complete a different just form. Additional information is not required but could help to ensure this • Juretia not misused or:marled to a different document . C' Indicate title or type of attached document number of pages and data. • Securely attach this document to the signed document 2008 Version CAPA v1.9.07 800-873-9865 www.NotaiyClasses.com t • SAFEWAY° May 17,2013 RE: Appointment of Agent Safeway,Inc. To Whom It May Concern: Please be advised that the firm of Assessment Technologies,Ltd., ("ATLTD")has been retained and granted power of attorney to represent the interests of the entity Safeway, Inc. with respect to all property tax issues and matters regarding all business personal property accounts with your office. Communications related to the appeals process should be mailed to: Assessment Technologies,Ltd. 121 Interpark,Suite 308 San Antonio, TX 78216' . Ailn:Safeway,Inc.Account Manager Please continue to send Tax bills and Assessment Notices to the owner on record. Thank you for your assistance in this matter. If you should have any questions or concerns please contact Teresa Jerry, Account Manager at(210)403-4436 or by email at Ueny@atechttd.com. • Sincerely, 9-- 'd Donn Matsuza i Asst.Tax Manager County of Contra Costa Ss State of California I hereby acknowledge that the foregoing is true and correct and that I am authorized by Safeway, Inc. to engage said agent -, $- -- Donn Matsuzaki Subscr\ed d sworn to this_day of August,2013 by Dorm Matsuzaki,a person known to me. ``` �HEo Or`��fr? Notary ubiic (with seal if used in that state) SEE AlCr RNIA CPTE Nn1rnR1A4 CER11F1 • Jurat • State of California • • Contra Costa • County of Subscribed and sworn to (or affirmed)before'me on this f1 day of AVlt -{-- 20 I2.7 by • POVir-) I`'1G proved to me on the basis of satisfactory evidence to be the person/who appeared before me. • . .,,, CAITLYN RAE TANKERSLEY ' r Commission N 1959074 C) i4�� rr Notary Public-California Signs a (Nohry seal) `j tv.," Contra Costa County - - My Comm.Expires Nov 3.2015 • • OPTIONAL INFORMATION • • INSTRUCTIONS POR COMPLETING THIS FORM . The wording of all Jurats completed in California after January I,7008 must belt;the form as set forth within this Swat.There are no esceplionr.((a Swat to be completed does not follow this font the notary must corned the verbiage by wing reprnt stamp contabdng the correct wording or attaching a D�SC£5PTlON OF THE ATTACHED DOCUMENT separate fret form such as this one which does contain proper wording. In addition,the notary must require an oath or c mnation from the docwnent �7 _ signer regarding the truthfulness of the contents of the document. The \12?OW] htkrt FAll !,/T krill- document most be signedAPIER the oath or affirmation.II the document war (Title.pr description of attached document)al, previously signed,fl mutt be re-signed in front of the notary public during the �`5(—�w{II t IMC . • pwatproeea. (Title or description of attached document continued) • State and County information must be the State and County when) the document signer(s)personally appeared before the notary public. Number of Pages •I Document Date • Date of notarization must be the date that the signer(s)personally appeared which must also be the same date eminent process is completed. • hint the name(s)of document signer(s)who peaondly appear at the time of notarization. (Additional information) • Signature of the notary publio mast match the signature on filo with the office of the county cleric • The notary seal impression must be clear and photographically reproducible. • . Iuryrossion mast not cover text or lines.Useal impression smudges,re-seal if sufficient area peamlts,otherwise complete a differml just form. C• Additional information is not required but could help to ensure this ' Jurat is not misused or■thnbed to a different document. • C. Indicate title or type of attached document,number of pages and date. • Securely attach this document to the signed document • 2008 Version CAPA v1.9.07 800-873-9865 www.NotaryClasses,com i PETITION FOR ABATEMENT OR REFUND OF TAXES ' 02O ,3 7 County: Weld CO Date Received -C/ / (Use Assessor's or Commissioners'Date Stamp) ' Section I: Petitioner, please complete Section I only. Date: 12/23/2013 Month Day Year Petitioner's Name: Safeway Inc Petitioner's Mailing Address: 1371 OAKLAND BLVD 200 WALNUT CREEK CA 94596 • City or Town State Zip Cede • SCHEDULE OR PARCEL NUMBER(S) PROPERTY ADDRESS OR LEGAL DESCRIPTION OF PROPERTY P0004635 1122 Av.Greeley I Petitioner requests an abatement or refund of the appropriate taxes and states that the taxes assessed against the above property for property tax year(s) 2011 and 2012 are incorrect for the following reasons: (Briefly describe why the taxes have been levied erroneously or illegally,whether due to erroneous valuation, irregularity in levying,clerical error or overvaluation. Attach additional sheets if necessary.) I Proper)© rC d at fair market value-including adjustments for obsolescence II��CC C'VED MAY 09 a. : . "en,WEPetitibfWtlWLD $�� a 139,6,D (_2011 )and $157,639 (2012 ) �:41: Value Year Value Year I declare,under penalty of perjury in the second degree,that this petition,together with any accompanying exhibits or statements, has been prepared or examined by me,and to the best of my knowledge,information and belief, is i true,correct,and complete. Daytime Phone Number) ) 1 Peti tioner's Si ure �7 —7 By U" AAJ DaytimePhoneNumber( `I 12-Z I L2 'Latter of agency must be attached when petition is submitted by an agent. If the Board of County Commissioners,pursuant to§39-10-114(1),C.R.S.,or the Property Tax Administrator,pursuant to§39-2-116,C.R.S., denies the petition for refund or abatement of taxes in whole or in part,the Petitioner may appeal to the Board of Assessment Appeals pursuant to the provisions of§39-2-125,C.R.S.,within thirty days of the entry of any such decision,§39-10-114.5(1),C.R.S. Section II: Assessor's Recommendation t" (For Assessor's Use Only) Tax Year an I Tax Year D-O/'Z Actual Assessed Tax Actual As 0 Tax Original 13-iilod, 3 101(.220 B 81zs,so II:3?41o9' A ut( (O Si cJ3`1S,a& Corm c4330 �6Z(49 SI 1011flb 18,2-SY.$C$ 3gy',/DCCf�Yi U'-I,2`f0 5 q(3`IS.3 `er Abate/Refund 9( `4 V l! O Assessor recommends approval as outlined above. If the request for abatement is based upon the grounds of overvaluation.no abatement or refund of taxes shall be made if an objection or protest to such valuation has been fled and a Notice of Determination has been mailed to the taxpayer,§39-10-114(1)(a)(I)(O),C.R.S. Tax year: Protest? O No ❑Yes (If a protest was filed,please attach a copy of the NOD.) Tax year: Protest? ❑No ❑Yes (If a protest was filed,please attach a copy of the NOD.) Assessor recommends denial for the following reason(s): V o L t IA t53-rro e i1. It3r� i I(i),O Cs quo . 4/2 Assessor or Deputy Assessor's ure 15-DPT-AR No.920-66/11 FOR ASSESSORS AND COUNTY COMMISSIONERS USE ONLY • • if (Section III or Section IV must be completed) Every petition for abatement or refund filed pursuant to ti 39-10-114,C.R.S.shall be acted upon pursuant to the provisions of this section by the Board of County Commissioners or the Assessor,as appropriate.within six months of the date of filing such petition.§39-1-113(17),C.R.S. Section III: Written Mutual Agreement of Assessor and Petitioner (Only for abatements up to$10,000) The Commissioners of County authorize the Assessor by Resolution No. to review petitions for abatement or refund and to settle by written mutual agreement any such petition for abatement or refund in an amount of$10,000 or less per tract, parcel,or lot of land or per schedule of personal property, in accordance with§39-1-113(1.5),C.R.S. The Assessor and Petitioner mutually agree to the values and tax abatement/refund of: Tax Year Tax Year Actual Assessed Tax Actual Assessed Tax Original Corrected Abate/Refund Note:The total tax amount does not include accrued interest.penalties,and fees associated with late and/or delinquent tax payments,if applicable. Please contact the County Treasurer for full payment information. Petitioner's Signature Data Assessor's or Deputy Assessor's Signature Date Section IV: Decision of the County Commissioners (Must be completed if Section III does not apply) WHEREAS,the County Commissioners of County,State of Colorado,at a duly and lawfully called regular meeting held on / / ,at which meeting there were present the following members: Month Day Year with notice of such meeting and an opportunity to be present having been given to the Petitioner and the Assessor of said County and Assessor (being present--not present)and Name Petitioner (being present—not present),and WHEREAS,the said Name County Commissioners have carefully considered the within petition,and are fully advised in relation thereto, NOW BE IT RESOLVED,that the Board(agrees—does not agree)with the recommendation of the Assessor and the petition be(approved--approved in part—denied)with an abatement/refund as follows: Year Assessed Value Taxes Abate/Refund Year Assessed Value Taxes Abate/Refund Chairperson of the Board of County Commissioners'Signature County Clerk and Ex-officio Clerk of the Board of County Commissioners in and for the aforementioned county,do hereby certify that the above and foregoing order is truly copied from the record of the proceedings of the Board of County Commissioners. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of said County this day of Month Year County Clerk's or Deputy County Clerk's Signature Note: Abatements greater than$10,000 per schedule,per year,must be submitted in duplicate to the Property Tax Administrator for review. Section V: Action of the Property Tax Administrator (For all abatements greater than$10,000) The action of the Board of County Commissioners,relative to this abatement petition,is hereby ❑Approved 9 Approved in part$ O Denied for the following reason(s): Secretary's Signature Property Tax Administrator's Signature Date 15-DPT-AR No.920-66/11 • • SAFEWAYa May 17, 2013 RE: Appointment of Agent Safeway,Inc. To Whom It May Concern: Please be advised that the firm of Assessment Technologies,Ltd., ("ATLTD")has been retained and granted power of attorney to represent the interests of the entity Safeway,Inc.with respect to all property tax issues and matters regarding all business personal property accounts with your office. Communications related to the appeals process should be mailed to: Assessment Technologies, Ltd. 121 Interpark, Suite 308 San Antonio, TX 78216' . Attn:Safeway,Inc.Account Manager Please continue to send Tax bills and Assessment Notices to the owner on record. Thank you for your assistance in this matter. If you should have any questions or concerns please contact Teresa Jerry,Account Manager at(210) 403-4436 or by email at(jerry®atechltd.com. • Sincerely, _ Donn Matsuza i Asst.Tax Manager County of Contra Costa Ss State of California I hereby acknowledge that the foregoing is true and correct and that I am authorized by Safeway, Inc.to engage said agei t. Donn Matsaz3)v Subscr ed e/d sworn to this_day of August,2013 by Donn Matsuzaki, a person known to me. Notary ob c (with seal if used in that state) SEE ATTACHED L� `�� GAuf0, CERFICATE TI '. • • Jurat State of California • • Contra Costa • County of • Subscribed and sworn to (or affirmed)before'me on this "1 day o£ / \ll<�ll�s • 20 is by • DCJilI'1 J�`(G { `>I/7-G ��( • proved to me on the basis of satisfactory evidence to be the person who appeared before me. • G i „ 2t5',�� b CCommi RAE TANKE9S74 �, /' •� J -�� `,��,.> / ! Commission Cotmmlssion N 1959074 LEY 1!f!?1 3s Notary Public-California Stria ttl (Nom nap Contra Costa County - My Comm.Expires Nov 3.2015 • • • • • OPTIONAL INFORMATION • • INSTRUCTIONS FOR COMPLETING THIS FORM . • The wording of al Jurotr cam-pitted to Caltfornta after Jemmy 3,2008 rout be in the form as set forth within this Jurat There are no exceptions.V'aAurat • to be completed doer not follow this form, the notary must cowed the verbiage by wing aprat stomp confabrtng the correct wording or attaching a • separate foot form such as-this one which doer contain proper warding. In DESCRIPTION OF THE ATTACHED DOCUMENT addition,the norar).must require an oath or cyfmnotion from the document `,. signer regarding the trutifulness of the contents of the document. The �{� V l��i 1171'�1.1'. {ll l/ l 1j'.��141- document must be signed AFTER the oath or afrnmtion.Vibe document was (7i-tlee-.pr description ofattacheddocument)-, prcvlously signed,it mart be re-signed In front of the notarypubpe during the `.1 1 _'p 4�1LI t I�r t�' J,aatproccu. (Title or description of attached d000ment continued) • State and County information most be the Sate and County where the ( document signers)personally appcazedbefore the notarypubllo. Number of Pages -1 Document Data • Date of notarization must be the data that the signer(*)personally appeared which must also be the same date thejurat process is completed. • 1®t the name(s)of document signet(s)who przaomlly appear at the time of notarization. (Additional information) • Signature of the notary public,must match the signature on Me with the office of the county cleric. • lie notary seal impression must be clear and photographically reproducible. Impression must not cover tart or lines.If seal impression smudges,reseal if sufficient area permits,otherwise complete a differentjvrat form. 1 G Additional infosmation is not required but could help to ensure this • Juratis not misused or attached to a different document, . • Indicate tide or type of attached document,number of pages and data. • Securely attach this document to the signed document • 2008 Version CAPA v1.9.07 800-873-9865 www.NotaryClasses,com CLERK TO THE BOARD PHONE: (970) 336-7215, EXT. 5226 X861 FAX: (970) 352-0242 1150 O STREET P.O. BOX 758 GREELEY, COLORADO 80632 COUNTY1 May 9, 2014 Safeway, Inc. 1371 Oakland Blvd 200 Walnut Creek, CA 94596 RE: SCHEDULE NUMBER: See Attached Dear Property Owner: This is to advise you that the Weld County Board of Commissioners will hear your petition for abatement or refund of taxes on the property described as: See Attached. The meeting is scheduled for Monday June 9, 2014, at 9:00 a.m., in the Chambers of the Board of County Commissioners of Weld County, Colorado, Weld County Administration Building, 1150 O Street, Assembly Room, Greeley, Colorado 80631. The Assessor is recommending that the Board deny your petition. You are not required to be present at this hearing; however, this is your opportunity to have your position heard, especially if your position is opposed to the Assessor's recommendation. If you intend to submit any documentation in support of your position for this hearing, all such documentation must be submitted to the Office of the Clerk to the Board and to the Weld County Assessor's Office at least seven calendar days prior to the meeting date in order for it to be considered at the scheduled hearing. If you have any questions concerning this matter, please do not hesitate to contact me at (970) 336-7215, Extension 5226. Sincerely, 41)61-6-J-1H Rafaela A. Martinez Deputy Clerk to the Board cc: Assessor Agent 2011 AND 2012 PETITION FOR ABATEMENT-SAFEWAY, INC PAGE 2 List of Schedule/Parcels: Owner Name County Schedule/Parcel Property Address Safeway Weld CO P0004635 1122 Ave Greeley Safeway Weld CO P2408703 1300 Dexter St. Ft. Lupton Safeway Weld CO P1809301 1535 Main St. Safeway Weld CO P1962001 1535 Main St. Safeway Weld CO P2027402 8134 14 Cr. Road Safeway Weld CO P2722504 4548 Centerplace Dr. Safeway Weld CO P3012005 4632 Centerplace Dr. Safeway Weld CO P0004634 3526 W. 10th St. Safeway Weld CO P2027302 820613 Cr. Road CLERK TO THE BOARD i lY PHONE: (970) 336-7215, Ext. 5226 1861 FAX: (970) 352-0242 II INE=1 SIIC115 O 2 P.O. BOX 758 \ GREELEY, COLORADO 8063 80632 mom illit%‘ COUNTY July 9, 2014 Safeway, Inc. 1371 Oakland Blvd Suite#200 Walnut Creek, CA 94596 RE: SCHEDULE NUMBER: See Attached List Dear Property Owner: On June 9, 2014, the Board of Weld County Commissioners considered your petition for abatement or refund of taxes and denied same. Pursuant to Section 39-2-125(f), C.R.S., you have the right to appeal this decision to the State Board of Assessment Appeals within thirty days. You may obtain the appropriate forms and instructions from: Board of Assessment Appeals, Department of Local Affairs, 1313 Sherman Street, Room 315 Denver, CO 80203 Phone: 303-866-5880 In preparation for appealing to the State Board of Assessment Appeals you may also go to the following state link to obtain any further information you may need to proceed, http://www.dola.state.co.us/baa/index.htm Very truly yours, ato -a Rafaela A. Martinez Deputy Clerk to the Board cc: Assessor RM/eg 2011 AND 2012 PETITION FOR ABATEMENT-SAFEWAY, INC PAGE 2 List of Schedule/Parcels: Owner Name County Schedule/Parcel Property Address Safeway Weld CO P0004635 1122 Ave Greeley Safeway Weld CO P2408703 1300 Dexter St. Ft. Lupton Safeway Weld CO P1809301 1535 Main St. Safeway Weld CO P1962001 1535 Main St. Safeway Weld CO P2027402 8134 14 Cr. Road Safeway Weld CO P2722504 4548 Centerplace Dr. Safeway Weld CO P3012005 4632 Centerplace Dr. Safeway Weld CO P0004634 3526 W. 10th St. Safeway Weld CO P2027302 8206 13 Cr. Road U.S. Postal Service,. LT CERTIFIED MAILTM RECEIPT -0 (Domestic Mall Only;No Insurance Coverage Provided) a- F r•silvery inf rmatbn vAlt ur we•atte et www.ue s.c mo r0 O I` u 1 Postage $ m O Certified Fee l7 Postmark O Return Receipt Fee Here (EndorsementR Required) Restricted Delivery Fee - (Endorsement Required) ru rL Total Postage 8 Fees o sent To Ov+. MM�2.- amtn# 1 o ,y r Street,Apt N ec ''yy or PO Box No. )24 ^n-1-,p&tcs %)tryja 3O8 City,State.ZIP+4 i eisiaisiiiiir SEN•E': C•M•LETE THIS SECT/S •euvENY • Complete items e,2,and 3.Also complete A item 4 if Restricted Delivery is desired. X i ❑Agent IN Print your name and address on the reverse O Addressee so that we can return the card to you. B1 Recetv by( nted ame) �. Date of Delivery • Attach this card to the back of the mailplece, Vh'"r�� 1v'SJf or on the front If space permits. D. is delivery address different from item 1? ❑Yes pAG 1. Article Addressed to: y if YES,enter delivery address below: O No &1n 1 - &C.Coun-'f' T2. AALta ink.nf- ` -emn .t tint 121 cQn vt o.yilc, StLatt3O 3. Service Type Q-rt_ i Tx —Niue ea Cernfled Mail ❑Express Mall O Registered ❑Return Receipt for Merchandise O Insured Mall O C.O.D. 4. Restricted Delivery?(Extra Fee) O Yes 2. Ankle Number (Transferfrom servicelobe 7004 2890 0003 5708 9653 PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 Hello