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Docuftn- <br />Certificate Of Completion <br />Envelope Id: 924COABDB3414698AD6BD714CC08FOB9 <br />Status: Completed <br />Subject: Complete with DocuSign: Indian River County 1 st ASA Amendment.pdf, Indian <br />River County Plan Acc... <br />Source Envelope: <br />Viewed: 9/28/2022 6:23:14 AM <br />Document Pages: 7 Signatures: 3 <br />Envelope Originator: <br />Certificate Pages: 5 Initials: 0 <br />Lilliane Anderson <br />AutoNav: Enabled <br />10 West Nationwide Blvd. <br />Envelopeld Stamping: Enabled <br />Columbus, OH 43215 <br />Time Zone: (UTC -08:00) Pacific Time (US & Canada) <br />anderl28@nationwide.com <br />Signed using mobile <br />IP Address: 155.188.183.80 <br />Record Tracking <br />Status: Original Holder: Lilliane Anderson Location: DocuSign <br />9/27/2022 1:30:17 PM anderl28@nationwide.com <br />Signer Events Signature Timestamp <br />oowsgn.d by: Aaron Henderson �� � I . J- Sent: 9/27/2022 1:36:01 PM <br />HENDEA3@nationwide.com D�►� Viewed: 9/28/2022 4:18:56 AM <br />Financial Services Rep XFOBCASIE67458 Signed: 9/28/2022 4:19:16 AM <br />Nationwide Retirement Solutions <br />Security Level: Email, Account Authentication Signature Adoption: Pre -selected Style <br />(None) Using IP Address: 149.19.40.32 <br />Electronic Record and Signature Disclosure: <br />Accepted: 9/28/2022 4:18:56 AM <br />ID: 32e76c91-d94f45ad-9ecb-2dccf40741 b 1 <br />ooc W -d by: <br />Adam Maloney EW846=052485.. Sent: 9/28/2022 4:19:17 AM <br />MALONEA4@nationwide.com � M Viewed: 9/28/2022 6:14:44 AM <br />NF Operations Director Signed: 9/28/2022 6:15:02 AM <br />Nationwide Retirement Solutions <br />Security Level: Email, Account Authentication <br />Signature Adoption: Pre -selected Style <br />(None) Using IP Address: 149.19.33.6 <br />Electronic Record and Signature Disclosure: <br />Accepted: 9/28/2022 6:14:44 AM <br />ID: 991 be 13f -8973 -4910 -9f43 -818128f29337 <br />Catherine M (Katie) Moore, <br />g -d by: <br />Sent: 9/28/2022 6:15:03 AM <br />MOOREK3@nationwide.com <br />aiuu'itAk M. (660 Mbbrt,� <br />1�4DM­ES30CWOWt <br />Viewed: 9/28/2022 6:23:14 AM <br />AVP Operations <br />Signed: 9/28/2022 6:23:22 AM <br />Nationwide Retirement Solutions <br />Signature Adoption: Pre -selected Style <br />Security Level: Email, Account Authentication <br />(None) <br />Using IP Address: 174.209.36.163 <br />Signed using mobile <br />Electronic Record and Signature Disclosure: <br />Accepted: 9/28/2022 6:23:14 AM <br />ID:527aaca6-488a-4477-94c9-f83ab4749c0e <br />In Person Signer Events <br />Signature <br />Timestamp <br />Editor Delivery Events <br />Status <br />Timestamp <br />Agent Delivery Events <br />Status <br />Timestamp <br />Intermediary Delivery Events <br />Status <br />Timestamp <br />Certified Delivery Events <br />Status <br />Timestamp <br />