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APPENDIX C <br />FORM OF ANNUAL CITY CERTIFICATION REGARDING <br />BUDGET AND APPROPRIATION OF DEBT SERVICE <br />The undersigned hereby states and certifies that: <br />(i) I am the duly appointed, qualified and acting of the City <br />of San Leandro, a charter city and municipal corporation duly organized and existing <br />under the Constitution and laws of the State of California (the "City "), and as such, I am <br />familiar with the facts herein certified and am authorized and qualified to certify the <br />same; <br />(ii) the City has previously issued its City of San Leandro 2012 Taxable <br />Pension Obligation Bonds in the aggregate principal amount of $ (the <br />"Bonds ") under an Indenture of Trust dated as of 1, 2012 (the "Indenture "), <br />between the City and U.S. Bank National Association, as trustee; <br />(iii) during the fiscal year commencing July 1, 20_ (the "Ensuing Fiscal Year "), <br />the aggregate amount of principal and interest coming due on the Bonds is $ ; <br />(iv) on , 20_, the City Council of the City duly adopted it Resolution <br />No. _ at a meeting which was called and held pursuant to law and with all public <br />notice required by law and at which a quorum was present and acting at the time of <br />adoption, adopting a budget for the City (the "Adopted Budget ") with respect to the <br />Ensuing Fiscal Year; <br />(v) pursuant to the Adopted Budget, the City has budgeted the payment of <br />Debt Service coming due during the Ensuing Fiscal Year on the Bonds; and <br />(vi) attached hereto is an extract from the Adopted Budget showing a line item <br />for payment of Debt Service coming due during the Ensuing Fiscal Year on the Bonds. <br />Capitalized terms used herein and not otherwise defined have the meanings <br />given them in the Indenture. <br />Dated: CITY OF SAN LEANDRO <br />I <br />Name: <br />Title: <br />C -1 <br />