Common use of ORIGINAL SIGNATURE AND NOTARIZATION REQUIRED Clause in Contracts

ORIGINAL SIGNATURE AND NOTARIZATION REQUIRED. I hereby certify that information provided in this specific project expenditure report is true and correct based on my knowledge and belief. I acknowledge and agree to comply with the requirement of section 2-354, of the Orange County code, to amend this specific project expenditure report for any additional expenditure(s) incurred relating to this project prior to the scheduled Board of County Commissioner meeting. I further acknowledge and agree that failure to comply with these requirements to file the specific expenditure report and all associated amendments may result in the delay of approval by the Board of County Commissioners for my project or item, any associated costs for which I shall be held responsible. In accordance with s. 837.06, Florida Statutes, I understand and acknowledge that whoever knowingly makes a false statement in writing with the intent to mislead a public servant in the performance of his or her official duty shall be guilty of a misdemeanor in the second degree, punishable as provided in s. 775.082 or s. 775.083, Florida Statutes. Date: Signature of ⌂ Principal or ⌂ Principal’s Authorized Agent STATE OF FLORIDA ) COUNTY OF ) The foregoing instrument was acknowledged before me by means of ☐ physical presence, or ☐ online notarization, this day of , 20 , by [NAME OF PERSON], as [TYPE OF AUTHORITY,… e.g. officer, trustee, etc.)] for INSTRUMENT WAS EXECUTED]. ☐ Personally Known; OR ☐ Produced Identification. Type of identification produced: [NAME OF PARTY ON BEHALF OF WHOM [CHECK APPLICABLE BOX TO SATISFY IDENTIFICATION REQUIREMENT OF FLA. STAT. §117.05] Notary Public My Commission Expires: (Printed, typed or stamped commissioned name of Notary Public)

ORIGINAL SIGNATURE AND NOTARIZATION REQUIRED. I hereby certify that information provided in this specific project expenditure report relationship disclosure form is true and correct based on my knowledge and belief. I acknowledge and agree to comply with the requirement If any of section 2-354this information changes, of the Orange County code, to amend this specific project expenditure report for any additional expenditure(s) incurred relating to this project prior to the scheduled Board of County Commissioner meeting. I further acknowledge and agree that failure to comply with these requirements amend this relationship disclosure form prior to file any meeting at which the specific expenditure report and all associated amendments may result in the delay of approval by the Board of County Commissioners for my above- referenced project or item, any associated costs for which I shall is scheduled to be held responsibleheard. In accordance with s. 837.06, Florida Statutes, I understand and acknowledge that whoever knowingly makes a false statement in writing with the intent to mislead a public servant in the performance of his or her official duty shall be guilty of a misdemeanor in the second degree, punishable as provided in s. 775.082 or s. 775.083, Florida Statutes. Date: Signature of ⌂ Principal or ⌂ Principal’s Authorized Agent Bidder Date Printed Name and Title of Person completing this form: ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇ Director of Business Development STATE OF FLORIDA ) COUNTY OF Orange ) The foregoing instrument was acknowledged before me by means of ☐ physical presence, or ☐ ☐X online notarization, this _13 day of December , 20 2022, by ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇ [NAME OF PERSON], as Officer [TYPE OF AUTHORITY,… e.g. officer, trustee, etc.)] for Unique Designs Professional Serv [NAME OF PARTY ON BEHALF OF WHOM INSTRUMENT WAS EXECUTED]. ☐ ☐X Personally Known; OR ☐ Produced Identification. Type of identification produced: [NAME OF PARTY ON BEHALF OF WHOM . [CHECK APPLICABLE BOX TO SATISFY IDENTIFICATION REQUIREMENT OF FLA. STAT. §117.05] ______________ _ Notary Public My Commission Expires: 05/29/2024 (Printed, typed or stamped commissioned name of Notary Public)