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APPENDIX C <br />FORM OF CERTIFICATE <br />OF NON -AD VALOREM ASSESSMENT ROLL <br />I HEREBY CERTIFY that I am the Mayor and authorized agent of Casselberry, Florida <br />(the "City"); as such I have satisfied myself that all property included or includable on the non -ad <br />valorem assessment roll for design and construction of the Sausalito Shores Subdivision Wall <br />(the "Non- Ad Valorem Assessment Roll") is properly assessed so far as I have been able to <br />ascertain; and that all required extensions on the above described roll to show the non -ad valorem <br />assessments attributable to the property listed therein have been made pursuant to law. <br />I FURTHER CERTIFY that, in accordance with the Uniform Assessment Collection Act, <br />this certificate and the herein described Non -Ad Valorem Assessment Roll will be delivered to the <br />Seminole County Tax Collector by September 15, 2019 in a compatible electronic medium. <br />IN WITNESS WHEREOF, I have subscribed this certificate and directed the same to be <br />delivered to the Seminole County Tax Collector and made part of the above described Non -Ad <br />Valorem Assessment Roll this day of o, % t�A— 2019. <br />0 <br />(SEAL) <br />Attest: <br />By: Lb?t_j&_� ©� � 21 <br />Donna G. Gardner, CMC <br />City Clerk <br />C-1 <br />CITY OF CASSELBERRY, FLORIDA <br />Charlene Glancy <br />Mayor/Commissioner <br />