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Docusign Envelope ID:430DA8ED-F2BF-4131-BE14-A60F4552B467 <br /> Authorized representative on behalf of Contractor must complete and sign the following: <br /> City of San Marcos <br /> Legal Name of Contractor <br /> Assumed Business Name of Contractor, if applicable (d/b/a or `doing business as') <br /> Texas County(s) for Assumed Business Name (d/b/a or `doing business as') <br /> Attach Assumed Name Certificate(s) filed with the Texas Secretary of State and Assumed <br /> Name Certificate(s), if any, for each Texas County Where Assumed Name Certificate(s) has <br /> been filed. <br /> VA <br /> l®� <br /> Sign ure of Authorized Re a entative Date Signed <br /> Stephanie Reyes City Manager <br /> Printed Name of Authorized Representative Title of Authorized Representative <br /> First,Middle Name or Initial, and Last Name <br /> 630 E Hopkins San Marcos, TX 78666 <br /> Physical Street Address City, State, Zip Code <br /> Mailing Address, if different City, State, Zip Code <br /> 512-393-8102 855-246-9100 <br /> Phone Number Fax Number <br /> citymanagerinfo@sanmarcostx.gov 069462869 <br /> Email Address DUNS Number <br /> 74-6002238 17460022381 <br /> Federal Employer Identification Number Texas Identification Number(TIN) <br /> N/A 17460022381 <br /> Texas Franchise Tax Number Texas Secretary of State Filing <br /> Number <br /> SAM.gov Unique Entity Identifier(UEI) <br /> Health and Human Services <br /> Contract Affirmations v.2.5 <br /> Effective November 2024 <br /> Page 14 of 14 <br />