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12
City of Pleasanton
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CITY CLERK
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AGENDA PACKETS
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2015
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100615
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12
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10/1/2015 11:27:44 AM
Creation date
9/30/2015 11:38:12 AM
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CITY CLERK
CITY CLERK - TYPE
AGENDA REPORT
DOCUMENT DATE
10/6/2015
DESTRUCT DATE
15Y
DOCUMENT NO
12
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111 <br />Business Signature Card <br />V2.2 1 25 14 <br />CHECK <br />ONE: <br />I <br />Signatures for New Accounts) <br />I <br />1 <br />Additional Signatures for <br />I listed Account(s) <br />II <br />l <br />Replace All Signatures on <br />I Account(s) listed below <br />Card of <br />— — <br />Customer Name: <br />CITY OF PLEASANTON <br />Address: <br />TITLE <br />City, State, Zip <br />Pleasanton, CA, 00000, USA <br />Telephone <br />Number: <br />Tax ID Number: <br />000000000 <br />Account Tide: <br />Account <br />Number(s): <br />TITLE <br />Accounts: <br />Please check <br />one: <br />0 All Accounts of Customer (Master Signature Card) <br />D Selected Accounts Only (complete Account Numbers section above) <br />(See attached list) <br />INSTRUCTIONS: Use BLACK ink. Place the Manual or Facsimile signature within th box boundaries only. Do Not overlap signatures. Reaulre? Indicate if the signature <br />is Manual or a Facsimile In the "PRINT NAME" box. For your security, cross out 11 unused signature boxes before signing the signature card below. <br />PRINT NAME <br />TITLE <br />SIGNATURE <br />DManual <br />OR <br />['Facsimile <br />E -MAIL ADDRESS <br />PHONE NUMBER <br />PRINT NAME <br />TITLE <br />SIGNATURE <br />❑Manual <br />OR <br />DFacsimlle <br />E -MAIL ADDRESS <br />PHONE NUMBER <br />PRINT NAME <br />TITLE <br />SIGNATURE <br />DManual <br />OR <br />❑Facsimile <br />E -MAIL ADDRESS <br />PHONE NUMBER <br />The undersigned certifies to JPMorgan Chase Bank NA (the "Bank") that (1) he/she is fully authorized to sign this Signature Card on behalf of the <br />Customer and certifies that all statements made on this Signature Card are correct and in accordance with the Customers internal account authorization, <br />organizational and governing documents, (2) each signature presented on this Signature Card is the signature of the named person, who is fully <br />authorized to sign and otherwise act on behalf of the Customer with respect to the Accounts identified in this Signature Card and (3) each Facsimile <br />(including trade or assumed names and marks) provided above has been authorized for use as an Account Signer/ signature. The Customer <br />acknowledges receipt of, and agrees to be bound by, the Bank's Account Terms and Service Terms, as may be amended or supplemented by the Bank <br />from time to time. The Customer acknowledges and agrees that: (1) each person named and Facsimile in this Signature Card is an Account Signer/ <br />signature and is authorized to be used to sign checks, endorse checks payable to t e Customer, conduct any transaction whatsoever or obtain any <br />information or obtain any service with respect to the Accounts subject to this Signat re Card; (2) the Bank is entitled to rely on the authority of each <br />Account Signer herein until the Bank receives written revocation of such authority; and (3) no notice of revocation will be effective until the Bank has a <br />reasonable opportunity to act on it. <br />Authorized Signature: <br />Officer Title: <br />Date. <br />Authorized Signature: <br />Officer Title: <br />Date: <br />INTERNAL USE ONLY THE ABOVE INFORMATION AND SIGNATURE(S) WERE VERIFIED BY: <br />Print Name: <br />Completion Date: <br />Initial <br />PN: 1125418 DOC ID: 2 <br />Page 3 of 51 <br />
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