Resolutions - Jersey City

c. 271 pÒLmCAL CONTIBUTION DISCLOSURE FORMR~quired Pursuant To N.J.S.A. i 9:44A-20.26 . .This form or its permitted facSimile must be submitted to the local unitno later than 10 day.s rior to the award of the contract.Part I - Vendor InformationVendor Name: I SunGardPublic Sector Inc.Address: ,11000 Business Center DriveformCity: ILake Marv" ,I State: FL I Zip:32746The undersigned being authonzed to certfy, hereby certifies that the submission provided herein representscompliance with the provisions ofN.J.S:A, 19:44A-20.2,6 and as represented by the Instrctions accompanying this. . zt~ DrlYfb:D. G~Al (¡F7 hø,.it- ~c.i:Signature Printed Name Title .Part II - Contribution DisclosureDisclosure requirement: Pursuant toN.J.S.A. 19:44A-20.26 this disclosure must include aU reportble.political contributions (more than $300 per election cycle) over the) 2 months prior to submission to thecommittees of the government entities listed on the fonn provided by the local unit:o Check~ere if disclosure is provided in electronic form.Contributor Name ReclDlent Name.Date Dollar AmountNot applicable.$, ,'J J....,..o Check here if the information is contInued on subsequent page(s)