Laserfiche WebLink
Page 9 of 9 <br />Answering YES does not preclude the City of Pleasanton from awarding a contract or taking <br />subsequent action related to the item. It does, however, preclude the identified City officer from <br />participating in any actions related to such an item. <br />By signing below, you certify you also agree to disclose to the City any future contributions <br />made to a City officer by you or your agent(s) after the date of signing this disclosure form, and <br />within 12 months following the approval, renewal, or extension of the requested contract. <br />I HEREBY CERTIFY UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE <br />STATE OF CALIFORNIA THAT THE FOREGOING IS TRUE AND CORRECT. <br />Signed: __________________________ Date: ________________ <br />Print Name: __________________________ Title: ________________ <br />Company: __________________________ <br />Jill Buck <br />Go Green Initiative <br />7/20/26 <br />CEO <br />Docusign Envelope ID: 9C07C040-E2F2-827A-8346-F09EEF08BF90