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Certificate Of Completion <br />Envelope Id: 41A15233E815447A97A34535047671E3 Status: Completed <br />Subject: Please DocuSign: FY2025 CSA_Sedgwick and COSL <br />Source Envelope: <br />Document Pages: 22 Signatures: 5 Envelope Originator: <br />Certificate Pages: 5 Initials: 0 City Manager's Office <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 />CMO@sanleandro.org <br />IP Address: 192.83.149.200 <br />Record Tracking <br />Status: Original <br /> 6/26/2023 4:21:15 PM <br />Holder: City Manager's Office <br /> CMO@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 />Signer Events Signature Timestamp <br />Michael Shook <br />michael.shook@sedgwick.com <br />Senior Vice President <br />Sedgwick Claims Management Services, Inc. <br />Security Level: Email, Account Authentication <br />(None) <br />Signature Adoption: Pre-selected Style <br />Using IP Address: 174.209.39.207 <br />Signed using mobile <br />Sent: 6/26/2023 4:28:28 PM <br />Viewed: 6/27/2023 4:16:54 AM <br />Signed: 6/27/2023 10:27:24 AM <br />Electronic Record and Signature Disclosure: <br /> Accepted: 6/27/2023 4:16:54 AM <br /> ID: fa159053-5dd1-4413-abf3-e3437c2cc64d <br />Richard Pio Roda <br />rpioroda@meyersnave.com <br />Principal <br />Signing Group: City Attorney <br />Security Level: Email, Account Authentication <br />(None) <br />Signature Adoption: Pre-selected Style <br />Using IP Address: 206.169.145.130 <br />Sent: 6/27/2023 10:27:26 AM <br />Viewed: 6/27/2023 12:00:16 PM <br />Signed: 6/27/2023 12:01:25 PM <br />Electronic Record and Signature Disclosure: <br /> Accepted: 6/27/2023 12:00:16 PM <br /> ID: 0b79bdfb-8c22-426f-a121-63dc0388b37a <br />Mayette Bailey <br />mbailey@sanleandro.org <br />Signing Group: Finance Available Funds Check <br />Security Level: Email, Account Authentication <br />(None) <br />Completed <br />Using IP Address: 192.83.149.205 <br />Sent: 6/27/2023 12:01:27 PM <br />Viewed: 7/5/2023 7:35:10 AM <br />Signed: 7/5/2023 7:35:37 AM <br />Electronic Record and Signature Disclosure: <br /> Accepted: 11/1/2022 9:01:21 AM <br /> ID: 3f00e764-6354-490c-8670-e07332d02d45 <br />Mayette Bailey <br />mbailey@sanleandro.org <br />Signing Group: Finance Director <br />Security Level: Email, Account Authentication <br />(None)Signature Adoption: Pre-selected Style <br />Using IP Address: 192.83.149.205 <br />Sent: 7/5/2023 7:35:39 AM <br />Viewed: 7/5/2023 7:36:39 AM <br />Signed: 7/5/2023 7:36:47 AM <br />Electronic Record and Signature Disclosure: <br /> Accepted: 11/1/2022 9:01:21 AM <br /> ID: 3f00e764-6354-490c-8670-e07332d02d45