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San Leandro Community Library Invoice #20-7132-1 <br />PLEASE COMPLETE AND RETURN THIS PAGE <br /> <br />CERTIFICATION <br />I hereby certify under penalty of perjury: that I am the duly authorized <br />representative of the claimant herein; that the claim is in all respects true, <br />correct and in accordance with law and the terms of the agreement; and that <br />payment has not previously been received for the amount claimed herein. <br /> <br />The claims the indicated allowance for the purposes of carrying out the <br />functions stated in its CLLS application and in Sections 18880-18883 of the <br />California Education Code. <br /> <br />San Leandro Public Library, 300 Estudillo Ave, San Leandro, CA 94577-4706 <br />SIGNED DATE <br /> <br />Signature - Authorized representative <br /> <br />Typed/Printed Name and Title of Authorized Representative <br /> <br />Email address of authorized representative <br /> <br />DocuSign Envelope ID: E6A2CB0F-40CC-4A12-BF54-7B6E6605AFF3 <br />In Process