CM-2025-310 - 12/12/2025 Docusign Envelope ID:C36534A6-F049-4B3E-BC7E-D573881303FBD
Page 1 of 1
CLAIM FOR ACTUAL MOVING EXPENSES
Print orTv,c All Information
1.Name of Claimant(s) Parcel No: Burge Parcel County:Williamson
Landon Burge
Project:Old Settlers Blvd
Residence ❑Business ❑Farm ❑Nonprofit ❑Sign ❑Other
2.Address of Property Acquired by City of Round Rock: 3.Address Moved To:
1001 N.Redbud Lane 413 CR 207
Round Rock,Texas 78664 Buckholts.Texas 76518
Claimant's Telephone No.: 512-848-7999
4.Occupancy of Property Acquired by City of Round Rock: 5.Distance Moved: 44 miles
From(Date): I To(Date of Move): 7.Mover's Name and Address:
1982 11-06-2025 A-Line Relocations
Owner/Occupant ❑Tenant 429 Doe Run
6.Controlling Dates Mo. Day Yr. Georgetown,Texas 78628
512-968-8883
a.First Offer in Negotiation 02 08 2023 9.Amount of Claim:
b.Date Property Acquired 2024 Moving Expenses $58,829.88
c.Date Required to Move 04 14 2024
8.Property Storage(attach explanation)
From(Date):N/A To(Date of Move):N/A
Place Stored(Name and Address):
N/A Total Amount S58,829.88
10.Temporary Lodging(attach explanation)
From(Date):N/A To(Date of Move):N/A
I I.All amounts shown in Block 9 were necessary and reasonable and are supported by attached receipts.Payment of this claim is requested.I certify that I
have not submitted any other claim for,or received reimbursement for,an item of expense in this claim,and that I will not accept reimbursement or
compensation from any other source for any item of expense paid pursuant to this claim.I further certify that all property was moved and installed at the
address shown in Block 3 above ', .v t.,•,, with the invoices submitted and agreed terms of the move and that all information submitted herewith or
included herein is true and • '' --11-- burl
e.
11 a5sa70aa9C
aunant
Date of Claim: 12/2/2025
Claimant
- ` t by '�.ZTT a"
I certify that I have examined this claim and substantiating documentation attached herewith and have round it to be true and correct and to conform with the
applicable provisions of State law.All items are considered to be necessary teasona ses, nd th tin is reco nmendcd for payment as follows:
Amount of S58,829.88 /
—02
Date a anon Cnl
I2) I21 2,o2 �i_ 1
Dale City of Round Rock Rep se .tiv•
C �t-26-3L0
DocuSign Envelope ID:514BE1A6-3896-4E5F-986A-F1914A0338D4
Form 1111-9 Request for Taxpayer Give form to the
(Rev.March 2024) Identification Number and Certification requester. Do not
Department of the Treasury Go to www.irs.gov/FormW9 for instructions and the latest information. send to the IRS.
Internal Revenue Service
Before you begin.For guidance related to the purpose of Form W-9,see Purpose of Form,below.
1 Name of entity/individual.An entry is required.(For a sole proprietor or disregarded entity,enter the owner's name on line 1,and enter the business/disregarded
entity's name on line 2.)
A-Line Relocation and Transport
2 Business name/disregarded entity name,if different from above.
3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1.Check 4 Exemptions(codes apply only to
c only one of the following seven boxes. certain entities,not individuals;
co
o see instructions on page 3):
c '❑ Individual/sole proprietor ❑ C corporation 0 S corporation ❑ Partnership ❑ Trust/estate
ei e ❑ LLC,Enter the tax classification(C=C corporation,S=S corporation,P=Partnership) . . . . Exempt payee code(if any)
o Note:Check the"LLC"box above and,in the entry space,enter the appropriate code(C,S,or P)for the tax
classification of the LLC,unless it is a disregarded entity.A disregarded entity should instead check the appropriate Exemption from Foreign Account Tax
o 2 box for the tax classification of its owner. Compliance Act(FATCA)reporting
❑ Other(see instructions) code(if any)
a` 0
3b If on line 3a you checked"Partnership"or'Trust/estate,"or checked"LW"and entered"P"as its tax classification,
2 and you are providing this form to a partnership,trust,or estate in which you have an ownership interest,check (Applies to accounts maintained
this box if you have any foreign partners,owners,or beneficiaries.See instructions 0 outside the United States.)
8 5 Address(number,street,and apt.or suite no.).See instructions. Requester's name and address(optional)
429 Doe Run
6 City,state,and ZIP code
Georgetown,Texas 78628
7 List account number(s)here(optional)
Part I Taxpayer Identification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding.For individuals,this is generally your social security number(SSN).However,for a
resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later.For other - -
entities,it Is your employer identification number(EIN).If you do not have a number,see How to get a or
TIN,later.
Employer identification number
Note:If the account is in more than one name,see the instructions for line 1.See also What Name and
Number To Give the Requester for guidelines on whose number to enter. 4 5 - 4 3 0 3 9 9 8
Part II Certification
Under penalties of perjury,I certify that:
1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and
2.I am not subject to backup withholding because(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding;and
3.I am a U.S.citizen or other U.S.person(defined below);and
4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct.
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid,
acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and,generally,payments
other than interest and d . aired to sign the certification,but you must provide your correct TIN.See the instructions for Part II,later.
Sign Signature of / 7/8/2024
Here u.S.person o3tcnxxsrm Date
General Instructions New line 3b has been added to this form.A flow-through entity is
required to complete this line to Indicate that it has direct or indirect
Section references are to the Internal Revenue Code unless otherwise foreign partners,owners,or beneficiaries when it provides the Form W-9
noted. to another flow-through entity in which it has an ownership interest.This
Future developments.For the latest information about developments change is intended to provide a flow-through entity with information
related to Form W-9 and its instructions,such as legislation enacted regarding the status of its indirect foreign partners,owners,or
after they were published,go to www.irs.gov/FormW9. beneficiaries,so that it can satisfy any applicable reporting
requirements.For example,a partnership that has any indirect foreign
What's New partners may be required to complete Schedules K-2 and K-3.See the
Partnership Instructions for Schedules K-2 and K-3(Form 1065).
Line 3a has been modified to clarify how a disregarded entity completes
this line.An LLC that is a disregarded entity should check the Purpose of Form
appropriate box for the tax classification of its owner.Otherwise,it
should check the"LLC"box and enter its appropriate tax classification. An individual or entity(Form W-9 requester)who is required to file an
information return with the IRS Is giving you this form because they
Cat.No.10231X Form W-9(Rev.3-2024)
A-Line Relocation
429 Doe Run
Georgetown,TX 78628 A-Line
+15129688883
Travis@ALineRelocation.com RELOCATION
www.ALineRelocation.com
Estimate
ADDRESS SHIP TO ESTIMATE# 1866
Landon Burge Landon Burge DATE 10/27/2025
1001 N Red Bud Ln 1001 N Red Bud Ln
Round Rock,TX 78665 Round Rock,TX 78665
TXDMV 00664581 C US DOT 2284558
•
ACTIVITY DESCRIPTION OTY RATE AMOUNT
Moving Contents of 40ft Shipping Container 8 800.00 6,400.00
MISC 20ft container and 2 40ft containers 1 9,500.00 9,500.00T
Packing Packing Guest house and garage 14 800.00 11,200.00
Moving Garage Contents 12 800.00 9,600.00
Travel Fee 11 760.00 8,360.00
Packing Materials 1 1,650.00 1,650.00T
Unpacking Unpacking Garage and guest house contents 14 800.00 11,200.00
VETERAN OWNED AND OPERATED SUBTOTAL 57,910.00
TAX(0.0825) 919.88
TOTAL $58,829.88
Accepted By Accepted Date
Danny Jackson
From: Lisa Dworaczyk <lisad@scrrlaw.com>
Sent: Tuesday, October 28, 2025 10:58 AM
To: Danny Jackson
Cc: Sam Nassour;Alexandra Brunner; Alison Davis; Mike Knott
Subject: RE: Old Settlers Blvd Burge Parcel Final Move
Approved.
Lisa Aworaczrz.!e
512-738-8731
From: Danny Jackson<danny.jackson@rowtx.com>
Sent:Tuesday,October 28, 2025 10:48 AM
To: Lisa Dworaczyk<lisad@scrrlaw.com>
Cc:Sam Nassour<sam.nassour@rowtx.com>;Alexandra Brunner<Alexandra@scrrlaw.com>; Alison Davis
<alison@scrrlaw.com>; Mike Knott<mike.knott@rowtx.com>
Subject: RE: Old Settlers Blvd Burge Parcel Final Move
Yea, packing personal property items and unpacking at the replacement are legitimate relocation costs.
Danny Jackson SRIWA, RIW-RAC, RJW-NAC, R/W-URAC
Project Manager
Right of Way of Texas, LLC.
Cell 512-922-5930
danny.iackson( rowtx.com
3411 Sam Bass Road
Round Rock,Texas 78681
❑• ti ❑
lo;+r
From: Lisa Dworaczyk<lisad@scrrlaw.com>
Sent:Tuesday, October 28,2025 10:28 AM
To: Danny Jackson <danny.jackson@rowtx.com>
Cc:Sam Nassour<sam.nassour@rowtx.com>; Alexandra Brunner<Alexandra@scrrlaw.com>;Alison Davis
<alison nc scrrlaw.com>; Mike Knott<mike.knott@rowtx.com>
Subject: RE: Old Settlers Blvd Burge Parcel Final Move
Danny
Is the cost for"unpacking"common in relocation benefits?
That seems like the bulk of the extra costs associated with both moves.
Lisa z woraczele
512-738-8731
From: Danny Jackson<danny.iackson@rowtx.com>
Sent:Tuesday, October 28, 2025 10:16 AM
To: Lisa Dworaczyk<lisad@scrrlaw.com>
Cc:Sam Nassour<sam.nassour@rowtx.com>; Alexandra Brunner<Alexandra@scrrlaw.com>; Alison Davis
<alison@scrrlaw.com>; Mike Knott<mike.knott@rowtx.com>
Subject:Old Settlers Blvd Burge Parcel Final Move
Lisa, hi
Landon Burge on Old Settlers Blvd is working to have the remaining items moved, I had the approved moving
company A-line relocation go out and update the inventory and provide an update move estimate to finish the
move, I have attached a copy of the move estimate.
Because the cost of the move has gone up from the original estimate I wanted to make sure that this was approved
before I give them the go ahead.
The original estimate was for two phases. Phase 1 was the move from the house to the garage apartment on the
remainder and phase 2 was from the garage apartment to the final location. The original estimate for both phases
of the move was in the amount of$103,166.00.
Phase 1 of the move was complete and paid, Phase 2 was started, and a portion of the personal property was
moved and this was paid there were some remining personal property items that were still to be
removed. Attached is the estimate to move these remaining personal property items in the amount of$58,829.88.
The amount paid to date for phase 1 and phase 2pt1 move is$72,489.00. adding in this final estimate to total cost
of the move will be 131,318.88 which exceeds the original estimate by$28,152.88. I spoke with the mover to
discuss this, and the main increase is there were additional items that were not part of the original estimate the
property owner decided to move which increased the costs in addition the property owner decided to have the
items unpacked at the replacement location which was not estimated originally.
Please review this move estimate and once approved the mover will start the move. The deadline for the
completion of the move and to submit any claims is December 8, 2025,therefore the owner is wanting to start and
finalize this move starting this week if all is approved.
If you have any questions, or need any additional information,please do not hesitate to call me.
Thanks,
Danny
Danny Jackson SR/WA, R/W-RAC, R/W-NAC, R/W-URAC
Project Manager
Right of Way of Texas, LLC.
Cell 512-922-5930
danny.lacksonarowtx.com
3411 Sam Bass Road
Round Rock,Texas 78681
•
o
O t•ry:-
2
Old Settlers Blvd
Burge Parcel
Replacement pictures 11-06-2025
I •- iD
Amain
•
l i •.
•
•
ww'
M •.9+� ' F- a •�. V
•
•t l
- •
111=1111111111111111111111EF
. - .. ... -
,...,
• ,5 - ..,
. .-
• •Tst:7---. '-Iss
IF ":'
0
. •
•.
_... .......-•"-•
......••••••••- *
0111".
•
l)
., .'
4: 'C
' _ - • -.'• It' .' .45•4 i:1 i, .'""V . I %i .
. _, . ' . r • -I ---‹ -r•
r 'it
1%; '\ . i ; • ',..il--. ,'. . VI. 0. IWF ••I
4 . -
IPIT
1
10'...,i -
W..'' • :.
_,.,a•-'-;.. -y. •',- .:k ,V\ii _ -. .,
1
II' 4 I
ii
" )
IN
'"erf -''•.; ,„ ."t` -• ''
110 .;,
. .
411411 i'.. 4
... 1 ',, .A . ..
'• '•:'?;•-: .)3.1'.'i '...P7'4.' ' .' •
1
. ed.' .. ,P ' 4...••• .s• .. ' ! •'`•--.. -• ;lti..X.I,..jC=*:-.'••,:r ?;1,11:: %.ht.iir - ''. -• .',Nei.. Vt.%:rt-••= ' ;A—y.. '1, ro".• '
e '
.,.-- •,,,it.4. .4__,,,_?, * r..,.., •••••Ni; % .
Artr,11:4.-v•-• '..7.,.- .4.1.,,,4,4.op—, ', *4'-,e, - . ----
41#
'T-'147i•,. '-''' - - • ..-10 - t, . ,.
' f5,- ' , •.„ 1 '
, *.••
ri ' •
... ;fp ..„......„
..._.---„--
,• \1 •
. ...• . . .
,
• ,,
• .
,,. .
,,
_. _ ..•
• '0 ) 11,-'
•• .*t., . - ;
• '
-.'s.,.•,,4.v ,.. . 1..:• ..,,:#.,44., ••-—
•''''.* •Attes,^..."''' - ,t ,...•.:„.;'. ...n1
-"... 1 '•
'. .4** ..dig ---‘2•-'*".." ''k. ' - .___
-... . ,
4.,...
_
.-
VII_
jAv.. Id_
...,
--__ ....
e ' ..-1-'".- IA. •
• ' .
1'; ••"St:,,,,..."....,,,- ."''' .„....s' 1117',,,,14/4',.."-. •' "'''M., ,•,1!'
.1". " ' ••..." • •
V, .,- 3•" .•.'''' s‘ '- ,, N. 'fle.
T..c.„..•-• ••••:., •v,..-. .,: it---,, •., , • -,, --(:),), 4 '. •
.e'il'I'64 't f• • 1„).• .• . - ' -•;••••.,.. •\‘''••.:',ft .,
' ---- '
' •"-ts•.' s, :'
•=" ,. .• '' ...• - ••,. ' ,•i;.41 • - •,&,,,I, + r j
t.
r 4 , mas._ :
Illk
A •
at, st 1
( 't i
i n
''•• '2(. 1-/ t•'i .....:.i4ie . •
•
-q `. .;� C f ;/ + • lay:
•Nkl
lit • ` • d . .i r.+ t; 4 :4 r�•`� F Y
Tft3
S.
•
•
•
. - 1 t• r1 � r. .e b.r ♦ �.`'� •rAt . ,:•('' , ZiXf t .l k . � 1
� ,• , � 5e ' ltw 'r ` z •"tfr >.„,� • F. r t,3 a n1ft,s/". • C ,F^d^ �_A tk, _t4.-. L- 1 -
.:,
4: ..
� h :,..Z
4.., .'' 1
i4#.- ',,:11L;.•...."•'--
R h t W.. ) ;
'11
? • .Y. "
- 'r f3 4 ' .i•: !I/5 . `t k shy '
.� s
L •.i a i, .I, > ,, ,'r^ f V..... 'a �h tt.
* k,(' ''441(0•-..1 r 1 Y r' -
'A"
. ; ,..
Aellb.
''•I'llti I n:: _ . 11011
. .1 1..4 .
a
_,
tor .
,,,......,e,t, r.
!---
ihNp, ,/ • ,N.
,.. ..,•;..,.,....,/
t+ ...
. . : : I
i • W.
. 4, . .41•— ,,„....
''... • ,?Age. ,
,a. AVa- • 1/4
r,
11111 - .. ......_ t "ii,, --
...WI.- :- - _, s,,
I
11101"1"tili 11 ..,.0.' - 7 1 1 _.
'
I t "lifil '
._. A... II
;ie • - .•‘..' ... 4
Aftw-Its1.. I vt -. I, • 11111. -11 li '1 '
. ,IIIPMW
. •••'.."..":"."44."."."-••• .
6 i'. •.',.., ' .
.6.-
..",-.e ''
,
••• *
-
-4•,••‘
•,-.., .
• - • - .,
'. . - `17"44.4"-"' "Oe"),, - ,-, . _•'' ... ;, _,
- • .6.
-.-..-v._.... .-,..'..f.-_ ... ......0 ,
, ...o --... ...- 4
-1'•e"W Z",'--• ' - 1 - --6 '' '..
- • Ai- ,
i
__.
r'-‘" . ,-^. •- ," ta • • If,'n ,-L,'" • - C•/ V ' '4'
it •..:- '.‘ •• ' 447.1 s.' Ziaft•rc . .-4 1k- ,
it4.1 -. '4,i' ''':-4 ''',"•'' ','Z''.11-. "ier'.4
- _ ...ite. 4... i. 2 ,,'1.,, •• • "A. • ,,i,,,,,,- •
- .
.L.1* ' 4 ,-,A.r4-4 „ • ,' 4.--.. - :-',-...... Je-4..
16* %. - .• : 4, . ..3>:..;,:.„..y ,,,
.. . - • _ *. -.
---
- . „...-,,, 4.tr• . _
. •t. •
•. . _.
---- -- '• ,,,::
,.." ..4.r. _ _ ,fflit
"*.
. r — •1 -4-- 1 .. • _ -
•- • ,...--
1,-airiir I. ,.... ilia ask_
....
-
f...--0, - a i ,. ....-
4,— - .
•
, . a • c., ...... •
•
----..-
......- . ..:;" , „... , ......, , ....._ .
11101111116'
��- i
trim.;:mili .
at
r I'
Ar ITIPIA," . \ \
`lh,-- , , 1$11:4"-' ''''' ! '.
t
.`Y •
{ 1
,.,_...._._4., qv'• '.: 41111:' .
_ ........_ . if
. ik,....4i,_. , „el_ ., . , i, I
441
., 1
!• t r.y 4, .c
"4a
' ram . �1\ ... .
. ...” - .
N. IIIIIIIIW,
. - ...-- . . ,
-1 ,, iiii , - ''''.-.-' ,,,,', ... .. . _----. \ Lkti' -
--4. i iii
III - - - i i
II i
i , • • ..Akee _ 1 ..,
-..„; .. , , , - .0.-.
,_ , . . . , ... 2,--. --.4.,
"iz......,....,...ar7.07)
.., ., ..- . . - , ,,,,, -,.•--, - ,. .. . .-117
___
.;- •• ' - '''`‘.. -'s" . Alt-- -; t-I- w•
1 A 4 ' •ii,' -----.....
s.-. c t • 4f if,t,-_,.....„..--L.,_ :, „Nh., , -1, .4;40,1.74: , *..; !
..., .-
,
• _,/ -.. - --,-.*''"i .r.C• s. ,.atifit , 0 . i .-, .. -.-..,..i.,,,,.
.
.,--
- .
• • ,,,--: , '•':' - , . f:,
114 . ...." ., • ,.... 5-...,,,.- .... .
. --15i..,1 '-4, .Is iiion •kei - • i i-
-,•
---.. .,.
. .
• .,!/:
.-__:. __i•. .,_ ..,,
.
04 -i. - -_-_„___s-..-
-__„,„:___:,.....
_ ., ....,
„...„ •
1 ,
. :
. .. .
. ..
IIIW• - . ' ...--.....
, -........„.....
----._.
• As ' ' .
wr,•7.!..'s
• ,
— .
,, .----
,..... .. , ...-, •---- ciiiellAN
\ ...,--..:,--., •
_ -. •••:,-
- •°-'',,' -,..1,-*
-.."!•TRIF— , , , r-404 we •
. 4, 9
,. ,4;%--: . -121°• • ". • -‘44"!,""'-
_,... , f - J
e o.• •
. ,
-A , , --' a-4•, ;':.:.:'-:' :,4'. • c . ,., ,
• k, L....,,..,Nk,,,,,-..-:.,-t.c;,.._,,,..
..
1.....:„...1. , - 4F;' '' ,N *# i .- - l."Y'•
.. , "..--Nil'i., • 4$r,:!.:..1.1.'..; ; ..... :...':::'''''..s,,
•,:q ."''.._. .....ici,P. - •••. '.. :..:...,., \... " _. . .
,„„„ -•". :,,• ..
'•• •••,...ti• .- -•••••••• „ ,,•
. ,
-
itt ..-•,,, . i 20. ,.,......
•
, • • tr..,,,:,-
. ....
. .., ...--
• i ••,•,.-,. , . . • I v -.,...4 - .. ,
•, ,.
&-
•••'i,-, ' 'e-P,. , ..-444
tt
•
-•.00 •.. .
. •-' **WI" -• •-••-- 4
S• A '',4:..'2,Si,;.;.•d..'
‘,.' • V....0.1"`1%' '#_ . • r • - - I,,,14 i'. ' It,
' •"lir:'.'-;-01_„3-'4::?'.."'. . ' ' ',` 44,,,.`:,;. - •'I.::... • . ,t P.'t,)(,=.',.. ..e;t:14'...-'';-.. , k ---"' -.' .- ' .'-• '
.. ..
- • _,
1".'"'.;_Ai`:.°.1. .,s, • ' 7.41.?!.4.. , tA.... -,-.4 - .'.. •,-, ...*:,. . tkr....iti., ' __.._ • -.... "-----,----,..,
i',1,4'-...",'' '4,,,--•_,,f•t,i4..--,.• • -•,-...iai-i,.. -:!%.•• - • "'.. r.-ii'..4 li •••••.: -,. _---‘ :•.--.:.-..-- ..4,Roft
'IA.
:,-,47,'' ', • •_.; ..-.41,
--: , 7.....:.'w, (115,.... . 4-4y,%,.... • .. . - , .. _ Id, - `'..•mp....-
,Ai,,.-.--.••...,,,;•,,•-;,. fr "1. -...1N *' — •,. *- ..;,• • .* - •-,
.. Ie\' k .
'cr.'*- .'*''' ; ' ••''',•. ". ‘*`. ‘-'. '• • - - --* **j 41;C't s, *- : ' , . V...4,0.,, ,
• • • *''' 1*. '. ,..:44';* _
, , •••••• ,, . - r, -•*
''.,e..•,,-.'7.,_.-r,'‘-'-:.s-•,-.--,;,,,.!'',.L,.•:.i-.-.,..-,-'•,.7:..,,,,!.':.•1-••••.',,:-=:•..•''7..:.=;';,,,-•,,..,..,-:';fr••-.•'tst••-;-..-'*'S.1,.1,r 1.,,1:.:''.)'•;''..,s.•,•.44.1".•".•".eNA.I.rV,*t*:.,.,-::.k",.:.g"•1,,',,..•,1,'-%*,:f.k*-•1\•/.V..1•3 k,..•..':4-,',,,',".e.,,.\,'f‘•‘lic,-,•,
'hAN,l4".t
'—. -•2-,‘.".;••--- v-•
...4",...'0/•;*.t.1ir0'Li't.0.i_7 A0..r,l'J'.'e•*.i;.'1 4..*._,,'-,,,.'.•.' , 'ft
:17: T - 1" f 4. 4 p
r .4 i ..-•,-v ,• • ,, ..-” .- ' , 1.v,•,fr.1'..,--.,`',r---.r,,,/,.,.•,*#1fe:*.••,.e-•.:'.*::—r.,':r”-'-4:•,'4
I.(.,.•-*,;.-'..•.-,'..
•.•.
- Al
,. .
• ,._ «,',.", ., • LL-.•.-• .4.-`,.....41 • -,7 -7.- ,1
•*--."4'
. .,
1,•"";;„il,;„*..•_-.
•Amill) ,,‘ `lie. "•.'7' '
-#7-,.:,:,a.','-•
i • '1* . . _,,,... . ,.•
--7,,,' --_••,,,„
' .1",.i:i•v. . •••...., , - --__ . •"'Me% .--
- _
. ,
' -., i ..•
.."•`'''-:••' ' ''''
ib.:,,,. . ,,..,_. v ... • ,..,.
N..,', ,,',. • ,,, 7 '.r.‘";i',tie...AL, ••••....'..., • '' . ' -.-••• n . .•
1..,.... 0,,..iit , n ,r4- • -
;'• , . ,;.i ,.... _,_:...,:;:•, -,•-. .,,.•7..,&--_____-,--.- s.,,,. ,...s(-•:•• ,,-
,--- "—- v-
". -s
' •
' '• - •" ,I. 71,' , : .' • 7 „ •
.N'. " :It 11.'Ic :\1 ' "- i- .,4-." .44.,„.,,, . ..- , ••
. ' ... • ',.--r' IT **. '-• 414.17...6.0.-+ ' A. ..—
=..•., -• - s•-- • w%,,":' .--•• ,'—'1 -0,•- * ', , ....,, ,,. ir. .,-...! . ,_, .• —,- ,...
•7.-, -,'4 e•-‘,.-• ..--. :%A,?,' •:. 4:47.ti...iV A.. -•• , :•1.1, '''''' 1 I ' .4'. •.'1‘ Z .
.... ,, .14 401'1,,.; . . •..i,“,- ; -Slif• .'..:,-.',4::,..i 4.',.,:
/. • -••- :- .;.t',.. ., I R ...,L--,:s :il '- $ A Li••••:,• I), . .'v "..1.1. 1 -0••..N.,• .„
- • 1%,"/•fii‘..'s 7, ,..k,1`1..I.;0.,--',N.'." 2i,...i, .. $ • .'. - 0.
'i. 4,4- , 'e. fl- e-- -L-..1.4. •- !L.,-.,-;' ,' w' . , •, sior. .: • ,. ,10' r ,A.,..
. , A
":•--'.- -1,4yik` :. ..,,,n 441,,c.c...y,---:,,..•
--:., ,. • -Ill*,. ,.' v. -7-A .ciiiw '- ' ---.`.
I., • - • — - ' ..‘. ..- -'Z'%.•A‘ -•''.... ......j.
.-,
''''..'‘....:
7.
1.....• .,. , -fa; ' '.\'- - ' '''s ' .e\ ... '. ' —
•;••••••=..01. :`,'..: •'.--;* : , • t ,.
7•.‘40 `, 't,.'s",:,.••,, ,..,4 -..,.., .. . • . .
''' .. ...kr..1%***- 4.- l'• ';.'''. ' .\''.• :'''-A,.,-!''4 ••t- ":. ..11'"-10,: ' * ,- - :-.. .
..,14.. :.trilf$••tt ., '
l'.'• ' t -: ,- ..."‘ ' '''•-1. ;,,,t.:,' ..0..",-;,,•' .„.• ....- •,:-.? *-:'4t
••„'''..•:,, .:*....tii,n4..,/ 1 •., • ..,;-5*.- •"‘-• 7.;,-14‘1"1:,•••t*'':,. -.(0. - r
,,,, • • .4.4 A _
i T .. IS;16:.', • '- i !.:rS . • ' ... ' ..te ..t;,*.., ", , :•," . . .'
`,:.\).'.'• y'• ..:-.vs,_ 446.4- ..-.1.3; ;1: ••:•.• -L 1 . . 1
tpj
..„. 40i i'•.•., 01,•. . , •, ,,;r.‘, • : . -, ' - -,z., •.: c- •
-...,...;r-.-• . -..-4*.7.
• ,,. -- '7::-"—: -\i;-.I.4, l'f. ' __. •
t•DA.V-,....,- :-,-.7 -.--..,•%h ''•: -',..,:i, a
• '‘\•cvk-.A°: - '.' ; -•- • 4r i
'.,:k. ., ‘i, ‘‘, .;,.!•s' '•• .*::'•01-.4t-'' , • . .4k• : ---
'r•
7/ -4
. —
•: .'••?...: ••• .* I 0 •
••• ,•• .- •••' •
„. t N • Z ,11.:it,:17,e.
.., .;•:".2'- '.• 7 . t ,
L'• .,;20' ,. t.".•.•0',t,0„•04.. • ,*. 0 - ••..,•7,?.... •Istje....i. - '•\ ' allid4 ••,.
:,•:: • 4 1 1, ' ik A,i, V; • 'N A .-,,':le.',f .t.'"t;" ''
%at.,;It ,-4- .. ..5,k ... ...,..•. .,.... „-.--....„..-. •••, ....,„4-, . .-.--
.:-If.,.4`4 ''‘t.. ''. r .
.-: .11/4-
''.4'i-:-.4-...! , ,,cifio. '4*,. .•.% — .. -...,sc
*.
e . ,,,--- c.ii$ :.'.,F,,, -_,,, .,;;;,, . I 4 ,N1
.•• or'0— --.•*4;:, -rttr7,-; - -'!;
os • *,:),qd„%-:,:,-;41,-`---... ' ili . 1 ; v.
i. \' : 1,i.si.3,A, ''' •:.,..-/ ,t4.- - i !p, '
•1,•• •<1-. `4..., .. i • ,. •,,' ..,..'. ,,,.0,.. r,
:.---..---'- '•-':' 'IL,-f.--v..,'-,-. Pi...A..... . i:'.• .''
-
• 1' -• ' 7"WiTr . ..-; ' . • • . I
.1 . It 4 •
. 71,1 it I I'•.,. '1.. ,r, ., ,
3on.,... 7' .! 71 -.' '. '
..... .
t 1 e':
14'7';...;.*• •' ' '‘ '''
I) • i ..
......: .•.. .R. : I i
4 4 •.4•:. .. 411
, . . , t
. ...
' • - I, . . • -• .
. ....— . .
•
-•,,,.*..'.liP . 4. Ifr
' • • 1 - ..7,4
11 INV& ,
. . -... ,
.-
• .,,
*.i.,. ,
I „ . . ...
U111..4 ,
ri, .,..4-.4- '.•*1'... i,V„,... , : -... ''''.. ;. atiti ' •
10...3-1440.0t4.. ..,:i 1 .r.f . ,. ,• ....t i ' ..'4:::::.:;'. .: ., ', )'1 , i''''.0 :.- -,A • -
t.-A...77-. ......„...... „.,, 7..4.. ,,.t_ : ... • . •i'.14',1Fi. ` • -
- -,• J.4. If •••
•;•••!..'.1.-4; '• Itt;.
k \-, -17.--- -. ,-.': ;•-; i. -7-
k,
4-t1 fl . ;..-.. . : t 'to •+'.*-',ial
ay-
•. ;• .
...... -4:-
,
'• 'll'i ir, , , 4
..•••< %•_ ' ,:.) j."..,'„'
:••• •!' '•j-.1. • .: . • I,4, ,.
.. ,
• ,, , : i.•. _,•:.A... • . - .... ..... k ,
. • . ,
( . . . . .. .
. 1
..:.
• ••••••• — - •-;••• .7,-• •:-. ,—•=; ; -J•-4 2.
Vipper-"`" , ".....: ', -, ,,,--,;•--...-2--, :!.,:,,.. •..,7,, e. 1kr%.;,-'•• <
'-.--il.,.. •. ' •.. .ii.44};...'‘:-.•e...4''.":=;•':, 2':i
, . -. •.1, 444-?' l',,2 V,„ 44 v it:
_ -
44
. .`Pi. - _ . • . „,,,, ,„,,.. _ __,„._ .,
''‘' (- ' " TaT.---''--1 .111kitk. ‘r:4'1.1':; ' ''...• , JO " '..r.I . ......_.-1-v.--- r,„ .
• - - ,
-.; _,-..--',• .;', !e-o-t--,,,-.. -i,44.-- -- _—.A..-- ‘,-,
.,.
,..
I-!!
4t ' 7 t .• - -•
'PI
..84.i.. .. ..-_i .,..
!AID•.4:,4
1
•
L. ._._
-,,,,.--...1..:..1-•,:.7:.4.-••4.',-. ...,.).,.4•t,.,....'-..i.,.:,,..'..-s.,.:i„0.•:'-....•,.•.•',.,.•-•...,...•_*,t•4,i..*r...,,'..,.-..5'.i,,"•}-•,-•..-
-•,."-.
•t"4v;-.:•—',`-e.- i'.A;:0:,','' -''''''4;:-":•-••-.•,..,V..''i'p'..,,.!, .,..';,'',.:;t-t-ft i',-,-.,..1..-:t',i--,-,..7.7p.-.•..7,i-.,.f"1-*T4‘;.:...:..7-.3,:•!_,,
,s.„ 0 er,
1, e •1 $ 's6. 7,...;•0 . •
- ?- .•:".'• .., 1,,t•••,- ,.7.2„.3.•.•• 101,...t. .. ,.... • -•,,,.:1 . kc • „ .:•••
:• :•• ; -4,. ' le-•__. , *.-.. , .,..4, „ ._ . I.
„
.....,- _, ,4-i• _.,,,..4,_-___,- - -.*40141c#,'Xtr 11•Y ', -•
' .''. . f..:,,,4 ,,,
' 4 4.1.- ' - -‘• , !II!!
• •.' '11' 3 ---- ---'---- ' .. ,.., --,. ' , , - ..„ „ . - ' . • ,4, •61.)
1... - ..- .
.. ..........,.,,,,:,,,...„„.4 __, . v. , •
to } . „,i,,,,,.................:,ima
! ..7
44:1111: '104- " .
\I . 1.
pr• i
* .''
'..-..
♦; ,. •fir
i
N.
•
R` '
o .0' 1
y
. A
' t '''. di
1'
41.. )1 1 "--
.':\11 \—% •,11/;1., .- •••,
, .
,y-
. .1
1
•I ,
aliom.....„ .....
, . „,........low-
..........".•""'-'"."''--------
,. .
,
, .
.
i
' fr ' I .
• I ,,
' ,. II \ •t j •
I ' :, ..__,i,.---:.:
, -;. 1 .,'f:', .: _.
' i . . . .
. \' ,,
*. . • r •
. 4 . .'- -1 '' i 1 Li li I . ' .
. 1 i .\\;_i ‘ k 1 • ..
. #. ..: le 'I's
. -, 1,). rill' .... ,
' ;..4 '•"'
1
.
k. ,. .
. _. .
,1" .1. C..
. .. 1 F
. ..,.......•
- 1 )' ' :•• • , •,
r
4
_.• :111111111.11111k • .
' i
.
•.'• I %
A
_ .
. .
,..
. :4.- .4 •---. . .
.'i 1 ji
&, L
.4i. : .. ...- _ _, . •
....o....0.....
s
I •--r-'-'4..V0,..4. '(
71 1I
i
or. . • ...
0'
1iiii mmonl° • e
0-
.
\ ll'—
—f*J. - vv.
al 11 ..
....
I .... ,
..-
.,-
4 '
i I Nik,
...,i
1 _ .
-j4:•-.,•-:,,;,.,k:,4,-., ._ -,4,!
'iv ' .4: • . .
. .
. ..
Pil•
--• '- .
.,._., .
- - ' ; 111111011
I T •. ! _ ig
'-`-/--
7.-_
*
--
,t -,.. .
.- .
ks ''1, ‘‘.• .43 —ip
. .. 1
1 4. iir
t., kit
,,....i.
1
• . --.
s*. - .7"-IAPir.• r r'- 1 t,_ '''.: ,
-
I • •
4 _
WI
.: LW
, ... ,
...
4.-
Ilt I l' I
it ..;• L
......
1,.• ...a.„---1
. ..
IOW f .
* I
' *
...... .
:. .
,..
•
.11 .4r
_ .
...
Is•-,, ,s...
.. It
.....
. .
. _.
....---
.., Ift.,,,',.4,....,„. .
—
_...,.-... ,,
t....,
....,. . . ,. .
..,._
1
-.11k.•
-
............- - ..,. ew
•
-..
4 l
41/4\ „is. — .,•
ft
. . .
,' ' •
14
11 :-
-...•AAL
".,
....
-...
-. , ..
.s.
if
iillib•
.. •
,
r,,, ..sitra 'j; ..,,' 4 /4, •-
, ..
,; c '- .. 11111WL 4::IV • ..,..
it A-• . , •
Ali_ .--- •--
.,.
II
.0--- ---
k
°
VI
_-,:.-Ni- i 1., i•-dlr.%...._..,
....
-T.- ,4 :. , -:-
-/- if i al
IV.
Pri
tr ...;
ow I.
.1 .
A
t ...-
` --•Z 7.;'..•- -4 ,;:'-• '
..1'1 -' . alf
4. .
t... - .
. . -..,
KO'
1. .".
....-.......
\
- 1
. t \
4.4i,.. • , .
t 414,441041' 1''
. ;. , '.-k. ...
- -
-0., i;,- •
,.-
\ ,..--
\
•.-,,. -..;.-,7.,!-.:-.-, , 1
- 1 ., '- !
.. .
....,..._,..
,_
1.-•-' 41/4.-,' -..,.
-........E.# .../-
ill ,P'' -.... 10.i' ••- _:,
alLI 1 II I 1111111* •
141 i.- AT/,
, ./\ N..,
: 'WAIL
.,.._.1
.t
•
•
''''Illim
_ aid
.4.,. •
8,Li•-•"' ---
___- pi; 4._ ,, , ...doili• ,-.i ,
. ._
. .
e-slaIIIIIIIIIIIIIDrisa ---- - -
...eis w,.. -t.........••NA um ....--,,
..e.
. .... .
1.r4r
' •i.:.:' ,1
Old Settlers Blvd
Burge Parcel
Vacancy Pictures 11-07-2025
f/L\
Oki ,_ _
_ n:.
At ' I 1 II
1. 1111111 a'
you
10
a:.
11,�i +iilii ii I i is ' P k ' .
/*!or 1
so Ole
, - fl Xpil
P41 ileiliS
INN 44-
M
.r
►7
F
a 1111 1--_
V'' -1A116. rill --I [ , ilt•iii:6.;
PI I ;
s� '1'i-. ' yr' •;'f rn ..''. :, ,• k�.vs„
s yL J 4:.
..... ••-•.•••-:", --.•.-• :*.-•'.°.f.,',7--...-7--??•-'. ....,.
. ..
.......1'
cf,7.7._. . . -...„,..„:;-,,,.:-,R.,•-'1,- i. --,,74.i
.., ,.-..t.....:4,..:...-.
•
...---&,.,--T-' ,.:1-:7'.'-':'-.',,,;:.'''. .-',:•-:-. '.' -
iiiiiiiiiiii." es i,1
11.1 -. •
41.,
d.-, ...
, 41 oil
-Y I*IL• f . ! . rilliiiaii p
. • • •IP ' _-..6 •
. • . es..... . ..•.14.".A...A.
. . . . •
'..., e. . -•
• 1.. .1 •''P
-A '
. ,
• • - ..N. -‘;. .,.. _.,'. ..• ; .. '..SrAllerr....*"..4;;;01,:••47" ' . ''',1.-
• .
',.....'•:-.tt.•; ;:•••.' . 1 •••••;_ _0, -. • . • '•'' ... .•••. ,- .°•;;;•,- • "-' ---%--"wdz: j/C' ' -'
rr -. ,,,,.. ....*:z1,2• *it'' ..4•V . ' -;4.,•••;• --. . .. -,'•°: •,••••„ -•,,•• ,gr,.• -•410-141‘;.•
.,__•4:plik• •. • .°,,,•:•:\V ;_.' .t: ' :. :°,,, •-,"..:•:•, ... •••4: -:-'1:-.-- •Iti.---.3..."0- 4..:„ "s, • • •
IA---na---- ' ... • •-. -:-.,-,;• • -.-••`', 7.1
i•111-' .. f.;', - -,:': . ':,. t•-•- -‘; - ' - --4,0:!. ;.:,.,-.. le-.- -_,,,v1;.-1.-...--.- --(:.:,_- 41.;‘, "--- -..
`.41:;‘ . -- -•'- -'• ... . A • -'•••'- '', --.st-',err' -•'''' .I'lk '•••°•;.---,:;°.,z '''
•., . . ..:4-i1r1,.....• • i 4.1 , * . t,•,.. : . ...-,,,;.**F rc ,. , -,•-. . .;-. •"!...-•••.•.•.,"•.";:••,i.-_;_,
-. -•-- . . ••*,..•.--• J''-..‘ -'. .• • •••,•4*•,..i .s`•41K-.. -5 :-'-. . ..:„- .,..!it- ; 4.. . :-.,-.4.'*7'..-: r....--
S. k,-
..:::... fc....:1, ' - —-i.-'-,' T''• ,..„1-••It\ib•i..-:•.:.4 x7i..:,•-,,r'7°.,..• . ,.. .
.....v-,. .
.1,- . .
. - .,...
. . .
. ,P. .
. ,
----*-
.
.051
. ,
litt
.
,..':w".4.i'. ',-;r`tic.3;,•4•,. , .
.• . . •
- •--s,„‹......••••4•••••-..;‘,1- %IL-;•.'• ,..-. • ill$4,iM•''i. • i'''' • ' -.,. • . •"a i.,•:\t•4,-,-0 .lz:-.-;',.••,.; .-, ' :•;1•••;'-4.-..-;•-.;.
••.;- - -:;.., • -trfr ‘ix,••.•;,,z•.--.......• :-. • •5.- ,,,t A '
tAt!._.-•' 1#..401.4.4tig: is',t:,*.'"'"t : , .,,,, ,,''•••.:t, , -'" . '.4 4.....f,, . V A•; •..'•• ,-;„ ,,,;(....•• . , ;,:„,.......,.•.,;-,...x
7 , 4;,,..''4:", ' - - -1,7 t- 74." i- - ' ''-.. .'',', .'-% .s. .''''. . • ,, -.....,, ,. ,,-„,-....
..i. . •
... . • . .• _,. ,
,,,,, , ....,„._ .,..,•,.,.. ..,- ,, ,.. .,.. ., . .•„,44,4,,A,„. ...ef ...• .,„ -,,, . . •, ,,.,;,, ,...•._,- _ ,... .... ...,. _,..a T: ';',Y••r..,.,••-.i-.. , ...,,- ,.. ..... ..w.
.•,.• :.i-••• ...:4••-, , .i;:.1.. ..; ,,,,.1:5 .,,,,•-•:.. .. ..;,;/4•41,„v 4-4,-:,,..•,...• 7. ' -:, ". „, :;44213 ^'' • , ..:,t.9t ,e-
•.', .,.... •;. .!..,.T.4,. . ,, it.4 ,, .K 4.,tfrt.; ,:::; .,_, ‘.1 At, 1. 7 ...- .:',A,zr. AI',. 1'1 .i , ,
W ,•. " . c• ,,,2 •' ° ;
- ,; •°.:•- ,.,-.• . ; ..i..••••°,-/-.N. f?..-_,•••., ..-71•04-1 ,-,.!rip'•- ,it'''?Allyfi',.`‘''', , ,y,' • - • vite4r,
. . .... ..1*, - - A' • ' .'4, --i; . 1441
1 --:."' 0 -.til' '•ir* e• :N4 '.' •.,t , . t .". .t.t ''t. .• t - '.
'• t .'4,,' ,4•A-..;51.,. . •-•‘...*.ozi;.'si.,',.- • N.',..';., - :. . -
.14-t-;:-..,..;... - - , - :,‘, . t• A
. . -.
'...!ti...,,.4 •••• -•;r% • r• • • - ''• 4,1,-.' . t. •••
A
•
le
otopirotsvoesomwsotstewtoirm . ., ,
ir'' • -. ,04,.:„4.„...)..
r ra ' I
•
J* ! '4l ik i♦ tI d µ 'ti! R• �; '+fie't`S.,lL�1 fir r,Y 4.F `%
-f
a yet 1 .1 r jjr ck. r�f.�,ii.� 1 T I y r s. ddllf 4* :t t, .. -•�..
�r j I•� �� �/� i ({ J .rt lT�`.x« ,.1[' ,,.....d4,
,� a r- ••`.,'Y` 4 .Y` ,rb 11�` y
• '� 'h 7'br't ' 4 1 p 1.: r I 7rT¢ t t r / it" • ' r' y
r R•7`r {L'•r. t ,. •'.,l li;��„1 . ,-5,: 1P6I
I t,. ' ,-�rti LSi .— �.;_„F
•
7
+ti ,. 1 .
'Yt-24T _
I°IL ice,'
aEC--
7,. .,fi., �.S• r Br ..0 7:
. i. f ......oh.
-: 5 •Cr.
1 e 4 r
a '. 7 t S *•
.Zl
7::1: 122,.. L' l,�,—. 'Li:4.C}ram: .�
DocuSign Envelope ID:02676472-EEB4-4C53-8E5C-397513A3584F
Page 1 of 1
CERTIFICATION OF ELIGIBILITY
Project: Old Settlers Blvd
Parcel: Burge
Displacee: Landon Burge
Individuals, Families and Unincorporated Businesses or Farming Operations
I certify that myself and any other party(ies) with a financial interest in this relocation assistance claim
are either:
IXI Citizens or Nationals of the United States
or
❑ Aliens lawfully present in the United States
* If an Alien lawfully present in the United States, supporting documentation will be required.
rL�DeccuS/igneed,by
" - turf- Date:6/19/2024
Claimant
Date:
Claimant
Incorporated Business, Farm or Nonprofit Organizations
I certify that I have signature authority for this entity and such entity is lawfully incorporated under the
applicable state's laws and authorized to conduct business within the United States.
N/A
Date:
Claimant