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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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Template:
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 /> is•v--�rr 'r'r-�•�v—-- •- v-^rr'n ' r-r•�e a i;•� -.c"�>>.c .c�'!..M.c:(�.M;.c'Y-SM.c Is.'s i' .c .cK>.�^-.c�.c oe'—Y�.c`Y�."c <br /> 1/See Attached Document (Notary to cross out lines 1-6 below) <br /> O See Statement Below (Lines 1-6 to be completed only by document signer[s], not Notary) <br /> 1 <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 /> ® <br /> County of SAAlT)9 13~X)Voq <br /> on this S day of MAY , 20 /7 , <br /> by Date Month Year <br /> (1) F/2EDFgic.e I4Joob <br /> (apd' (2) ), <br /> NameJ)'of Signe <br /> • SHARON LOREN ACOSTA proved to me on the basis of satisfactory evidence <br /> 72; `'} ' COMM. #2107875 to be the person'who appeared before me. <br /> -�, NOTARY PUBLIC-CALIFORNIA s• <br /> SANTA BARBARA COUNTY o /V <br /> Comm.E"�iree April 20,2019 N <br /> Pweuu��w�wuu�w�wuw�wasA+w.+e.e d9 Signature <br /> Signature o 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:(40/1/PlI T OF .fivrEzesr Document Date: / A <br /> ® Number of Pages: N/#'� Signer(s)Other Than Named Above: A R- <br /> L[�G�✓Gvgm.'yi`✓:�G�gr!G�i�y, qt!'ytv'.�r� S� G�m,Aa:A2!L�'d4�-m--'-d.-d-'ems -.vgei-'d,'u.'a.'dAa'ti0.�Ag''d"a'A�L-'d'd•. <br /> ©2014 National Notary Association • www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item #5910 <br />
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