Playing Smart changelabsolutions.org | kaboom.org 167 - 14 - instrument, on oath stated that ____ was authorized to execute the instrument and acknowledged it as the _______________________ of Lake Washington School District No. 414, a Washington municipal corporation, to be the free and voluntary act of such party for the uses and purposes mentioned in the instrument. DATED: _____________________, 2004. _______________________________________ ___________________________[Print Name] NOTARY PUBLIC in and for the State of Washington, residing at __________________ My commission expires: _________________ STATE OF WASHINGTON ) ) SS COUNTY OF KING ) I certify that I know or have satisfactory evidence that Ben Yazici is the person who appeared before me, and said person acknowledged that he signed this instrument, on oath stated that he was authorized to execute the instrument and acknowledged it as the City Manager of the City of Sammamish, a Washington municipal corporation, to be the free and voluntary act of such party for the uses and purposes mentioned in the instrument. DATED: _____________________, 2004. _______________________________________ ___________________________[Print Name] NOTARY PUBLIC in and for the State of Washington, residing at __________________ My commission expires: _________________ 309\G:\LWSD\MISC\SamSchoolDistInterlocal.2004-04-12.doc
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