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Certificate Of Completion <br />Envelope Id: 69BC57DE780346B2B0F63A6AA91BA345 Status: Completed <br />Subject: Complete with DocuSign: Black Chamber TA Grant.pdf <br />Source Envelope: <br />Document Pages: 4 Signatures: 2 Envelope Originator: <br />Certificate Pages: 5 Initials: 0 Lucie Johnova <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 />ljohnova@sanleandro.org <br />IP Address: 192.83.149.200 <br />Record Tracking <br />Status: Original <br /> 12/19/2023 10:14:27 AM <br />Holder: Lucie Johnova <br /> ljohnova@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 />Fran Robustelli <br />frobustelli@sanleandro.org <br />City Manager <br />Signing Group: City Manager <br />Security Level: Email, Account Authentication <br />(None) <br />Signature Adoption: Pre-selected Style <br />Using IP Address: 76.14.58.14 <br />Sent: 12/19/2023 10:18:14 AM <br />Viewed: 12/19/2023 10:28:07 AM <br />Signed: 12/19/2023 10:28:18 AM <br />Electronic Record and Signature Disclosure: <br /> Accepted: 12/19/2023 10:28:07 AM <br /> ID: 888d4c53-643d-49d1-ba65-ad66c4fea766 <br />DeWayne Cornelious <br />dewayne@stsonsite.com <br />Owner <br />STS Onsite <br />Security Level: Email, Account Authentication <br />(None) <br />Signature Adoption: Pre-selected Style <br />Using IP Address: 45.25.142.78 <br />Sent: 12/19/2023 10:28:19 AM <br />Viewed: 12/20/2023 9:02:38 AM <br />Signed: 12/20/2023 9:03:56 AM <br />Electronic Record and Signature Disclosure: <br /> Accepted: 12/20/2023 9:02:38 AM <br /> ID: ec9eed1f-1977-4f17-ab0a-8425158c36ae <br />In Person Signer Events Signature Timestamp <br />Editor Delivery Events Status Timestamp <br />Agent Delivery Events Status Timestamp <br />Intermediary Delivery Events Status Timestamp <br />Certified Delivery Events Status Timestamp <br />Carbon Copy Events Status Timestamp <br />Dhez Woodworth <br />dwoodworth@sanleandro.org <br />Security Level: Email, Account Authentication <br />(None) <br />Sent: 12/20/2023 9:03:57 AM <br />Electronic Record and Signature Disclosure: <br /> Not Offered via DocuSign