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RFP No. 17-04-01 Informational Touchscreen Kiosks and Software Services
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Last modified
5/25/2017 3:24:37 PM
Creation date
5/25/2017 3:24:37 PM
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CityClerk-Bids_RFP_RFQ
Project Name
Informational Touchscreen Kiosks and Software Services
Bid No. (xx-xx-xx)
17-04-01
Project Type (Bid, RFP, RFQ)
RFP
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CALIFORNIA JURAT WITH AFFIANT STATEMENT GOVERNMENT CODE §8202 <br /> C .-.c-PA^P,e<sA-<)c R,tc-A4-C2 c Ac�i <br /> G✓See Attached Document (Notary to cross out lines 1-6 below) <br /> ❑ See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary) <br /> 2 <br /> 3 <br /> 4 <br /> 5 <br /> 6 <br /> Signature of Document Signer No. 1 Signature of Document Signer No. 2 (if any) <br /> A notary public or other officer completing this certificate verifies only the identity of the individual who signed the <br /> document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. <br /> State of California Subscribed and sworn to (or affirmed) before me <br /> County of SAIVM .1Sp'feeme ' <br /> on this 5 day of NM/ , 20 /7, <br /> by Date Month Year <br /> (1) FREDEA/C.e 2,tJD0,0 <br /> (9jad (2) ), <br /> SFL4RJN LOREN ACOSTAA Nameja'f of Signer <br /> p . C,OMM. *2107875 <br /> (" -1;, NOTARY PUBLIC-CALIFORNIA S. <br /> 4 �%. t-, SANTA BARBARA COUNTY o proved to me on the basis of satisfactory evidence <br /> ' r My Cemm.cx�ires April 20,20 a to be the person(' who appeared before me. <br /> �w.ewwwwwwwwwwwwwwwwwn>wwuwwwe.•.w <br /> / / <br /> i <br /> Signature _ J t� <br /> Signat e •f Notary Public <br /> Seal <br /> Place Notary Seal Above <br /> OPTIONAL <br /> Though this section is optional, completing this information can deter alteration of the document or <br /> fraudulent reattachment of this form to an unintended document. <br /> Description of Attached Document <br /> Title or Type of Document:A/0A/-COCGuSioA/ .P=rp#9viT Document Date: NIA- <br /> ® Number of Pages: Signer(s)Other Than Named Above: Ai/A <br /> -.•.. • - <br /> ©2014 National Notary Association •www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5910 <br />
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