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<br /> <br /> <br />Certificate Of Completion <br />Envelope Id: C60B747D14C24F7DB1FE9C8FB57DABCE Status: Sent <br />Subject: Please DocuSign: La Clinica CAP Grant FY21-23 - CSA 07012021 <br />Source Envelope: <br />Document Pages: 20 Signatures: 0 Envelope Originator: <br />Certificate Pages: 5 Initials: 0 Pauline Tabilang <br />AutoNav: Enabled <br />EnvelopeId Stamping: Enabled <br />Time Zone: (UTC-08:00) Pacific Time (US & Canada) <br />835 E 14th St <br />San Leandro, CA 94577 <br />ptabilang@sanleandro.org <br />IP Address: 192.83.149.200 <br />Record Tracking <br />Status: Original <br />8/16/2021 1:58:51 PM <br />Holder: Pauline Tabilang <br />ptabilang@sanleandro.org <br />Location: DocuSign <br />Security Appliance Status: Connected Pool: StateLocal <br />Storage Appliance Status: Connected Pool: City of San Leandro Location: DocuSign <br /> <br /> <br />Jane Garcia <br />ndhillon@laclinica.org <br />Security Level: Email, Account Authentication <br />(None) <br />Electronic Record and Signature Disclosure: <br />Accepted: 8/16/2021 6:55:46 PM <br />ID: c79d7042-0c77-48a5-bba2-2d9e0d54db97 <br /> <br />Jeanette Dong <br />jdong@sanleandro.org <br />Security Level: Email, Account Authentication <br />(None) <br />Electronic Record and Signature Disclosure: <br />Accepted: 6/11/2020 4:38:36 PM <br />ID: e5e0a5ff-c3be-42e3-8948-59139c99db1a <br />City Attorney <br />Signing Group: City Attorney <br />Security Level: Email, Account Authentication <br />(None) <br />Electronic Record and Signature Disclosure: <br />Not Offered via DocuSign <br />Budget and Compliance Manager <br />Signing Group: Budget and Compliance Manager <br />Security Level: Email, Account Authentication <br />(None) <br />Electronic Record and Signature Disclosure: <br />Not Offered via DocuSign <br />Finance Director <br />Signing Group: Finance Director <br />Security Level: Email, Account Authentication <br />(None) <br />Electronic Record and Signature Disclosure: <br />Not Offered via DocuSign <br />Sent: 8/16/2021 2:03:12 PM <br />Viewed: 8/16/2021 6:55:46 PM <br />Signer Events Signature Timestamp <br />DocuSign Envelope ID: C60B747D-14C2-4F7D-B1FE-9C8FB57DABCE