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State of Minnesota -U.S. Bank Commercial Card Solutions -Participating Addendum <br />Contract# 75413 Purchasing Card Contract# 75427 Fleet Card <br />Appendix A, Document 1 -Minnesota CPV Member Addendum <br />Before completing the Certificate of Authority, please read: <br />• If the document being signed was "approved as to form" by an attorney, it is not necessary to complete the attached <br />Certificate of Authority (C of A). <br />• If the document was not "approved as to form" by an attorney, please complete the attached C of A (page 2). <br />• Be sure to dale all documents upon signing. Undated documents cannot be accepted and will be returned for <br />dating. <br />SIGNING INSTRUCTIONS FOR <br />CERTIFICATE OF AUTHORITY <br />Note that three (3) different individuals must sign and date the C of A. ff the Entity does not have three individuals who <br />are authon'zed to sign on behalf of the Government Entity, please refer to page 3. <br />SECTION 1 Organizational Information-Enter the legal Entity name and the tax ID number on the C of A. Note: <br />The legal name of the Entity name is required. The legal name is usually the name on the Government <br />Entity's financial statements. <br />SECTION 2 Authorized Persons -The individual who signed the Card Addendum/Amendment must complete and <br />sign Section 2. <br />SECTION 3 Execution Requirement -Check only™ box in Section 3 to Indicate how.many individuals (either 1 or <br />2) that the Entity requires to sign legal documents on behalf of the Government Entity. <br />SECTION 4 Execution -No action required. <br />SECTION 5 Certification -Two (2) individuals must sign and date Section 5 as well as insert their names and titles. <br />Note: The individual(s) who signed Section 2 cannot sign in Section 5 or this document is invalid. <br />• An officer of the Entity ("Officer One") is required to sign the top area of Section 5 attesting to the signatures In <br />Section 2. <br />• One other officer of the Entity ("Officer Two") must sign the bottom area of Section 5 affes/ing to the signature of <br />Officer One. <br />Please see examples below: <br />5, Certification. I certify that I am the __ and I am acting in my official capacity as an authorized officer who has <br />been given the authority by the Entity to certify that the Authorized Person(s) has/have the full power and authority under <br />applicable law and the governance rules relating to the Entity to execute and deliver to U.S. Bank, on behalf of the <br />Government Entity, and to bind the Entity under, the Documents for the purpose of establishing and extending the <br />Services. I also certify that the name(s) and title(s) of the Authorized Person(s) set forth above are correct and that the <br />signature appearing beside each name is a true and genuine specimen of his/her signature. <br />fi Printed Name of the __ of the Entityfi (Cannot be an Authorized Person listed in Section 2) <br />fi Signature of the __ of the Entltyfi Date <br />I certify that I am an officer of the Government Entity, and as such, I certify that the above-named __ is acting in such <br />capacity on behalf of the Government Entity, the signature below is my genuine signature and the signature above is the <br />genuine signature of such __ . <br />fl Printed Name & Title of Individual Signing Below & (Cannot be an Authorized Person listed in Section 2) <br />fi Signature* Attested by One (1) Other Individual of the Government Entity Date <br />Page 10 of 37