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<br /> <br /> <br /> <br /> <br /> <br /> BALLOT MUST BE SIGNED TO BE COUNTED <br /> <br /> <br /> <br /> Certificate <br /> <br /> I certify that the vote cast above has been cast in accordance with the will of the majority of <br /> the governing body of the public entity named below. <br /> <br /> Witness by hand, this day of , 2010. <br /> <br /> <br /> <br /> Signature of Authorized Official Title <br /> <br /> <br /> <br /> Printed Name of Authorized Official j { <br /> E <br /> f' <br /> l <br /> L / <br /> Printed name of Political Entity <br />