REPORT OF FINAL SALE California Debt and Investment Advisory Commission 915 Capitol Mall, Room 400, Sacramento, CA 95814 P.O. Box 942809, Sacramento, CA 94209-0001 Tel.: (916) 653-3269 FAX: (916) 654-7440 CDIAC #: Under California Government Code Section 8855(i), "The issuer of any new public debt issue shall, not later than 45 days after the signing of the bond purchase contract in a negotiated or private financing, or after the acceptance of a bid in a competitive offering, submit a report of final sale and official statement (or alternate bond documents) to the Commission. The Commission may require information to be submitted in the report of final sale that is considered appropriate." ISSUER NAME: (If pool bond, list participants) ISSUE NAME: IF THIS IS A POOLED FINANCING, WHICH ISSUANCE STATUTE IS IT AUTHORIZED UNDER? 1) Marks-Roos Local Bond Pooling Act 2) JPA Law 3) Installment Sales Agreement, Lease… 4) Housing Revenue Bond Law & Industrial Development Bond Law 5) Other ________________ ACTUAL SALE DATE: (Date Purchase Agreement Signed/Bid Acceptance) PRINCIPAL SOLD: $ DATED DATE: IS ANY PORTION OF THE DEBT FOR REFUNDING?1 No Yes, refunding amount (including costs) $  Issuer Contact: Name: Address: Phone:  Title: City, State, Zip: ISSUER LOCATED IN COUNTY E-Mail: Filing Contact: Name of Individual (representing: Bond Counsel, who completed this form and may be contacted for information: Name: Address: Phone: Issuer, Financial Advisor, or Lead Underwriter) Firm/Agency: City, State, Zip: E-Mail: Send acknowledgement/copies to: E-Mail: Name of individual to whom an invoice for the CDIAC issue fee should be sent:2 Name: Address: Phone: 1 2 Firm: City, State, Zip: E-Mail: Section 53583(c)(2)(B) of the California Government Code requires that any local agency selling refunding bonds at private sale or on a negot iated basis shall send a written statement, within two weeks after the bonds are sold, to the CDIAC explaining the reasons why the local agency determined to sell the bonds at a private sale or on a negotiated basis instead of at public sale. This fee is authorized by Section 8856 of the California Government Code and is charged to the lead underwriter or purchaser of the issue. The fee is administratively set by the Commission. The current fee schedule may be obtained from CDIAC. G:Data Unit\Forms\Final form.doc, Revised 7/11/2012 American LegalNet, Inc. www.FormsWorkFlow.com CDIAC: Report of Final Sale Page 2 FINANCING PARTICIPANTS (Firm name) OFFICE LOCATION (City/State) FINANCIAL ADVISOR: LEAD UNDERWRITER/PURCHASER: BOND COUNSEL: CO-BOND COUNSEL: TRUSTEE/PAYING AGENT: PLACEMENT AGENT: MATURITY SCHEDULE Attached IS THE INTEREST ON THE DEBT EXEMPT FROM TAXATION? Included in Official Statement MATURITY STRUCTURE Serial (S) Under State Law: No (taxable) Yes (tax-exempt) Under Federal Law: No (taxable) Yes (tax-exempt) If the issue is federally tax-exempt, is interest a specific preference item for the purpose of alternative minimum tax? Yes No Term (T) Serial and term bonds or two or more term (B) FINAL MATURITY DATE: INTEREST TYPE: FIRST OPTIONAL CALL DATE: SENIOR/SUBORDINATE STRUCTURE Yes No OFFICIAL STATEMENT/OFFERING MEMORANDUM: Enclosed None prepared NIC - Int. Cost: % TIC - Int. Cost: % Variable CAPITAL APPRECIATION BOND: Yes No WAS THE ISSUE INSURED OR GUARANTEED? No Bond Insurance (I) Letter of Credit (L) State Intercept Program (T) Other (0) ISSUANCE COSTS AND FEES: A) Management Fee $ GUARANTOR: Underwriter Spread or Discount $ ENHANCEMENT EXPIRATION DATE: D) Bond Counsel $ INDICATE CREDIT RATING: E) Co-Bond Counsel $ (For example, "AAA" or "Aaa") F) Disclosure Counsel $ G) Financial Advisor $ H) Rating Agency $ I) Credit Enhancement $ J) Trustee Fee $ K) Placement Agent $________________________ L) Other Expenses $ Not Rated Rated Standard & Poor’s: Fitch: Moody’s: Other: REASON FOR NEGOTIATED REFUNDINGS If the issue is a negotiated refunding, indicate the reason(s) why the bonds were issued at a private or negotiated versus a competitive sale. (1) Timing of the sale provided more flexibility than a public sale (2) More cost savings were expected to be realized than a public sale (3) More flexibility in debt structure was available than a public sale (4) Issuer able to work with participants familiar with issue/r than a public sale (5) All of the above (6) Other (please specify) B) Total Takedown $ C) Underwriter Expenses $ Total Issuance Costs $ ORIGINAL ISSUE PREMIUM $ ORIGINAL ISSUE DISCOUNT $ NET ORIGINAL ISSUE DISCOUNT/PREMIUM $  Revised 7/11/2012 American LegalNet, Inc. www.FormsWorkFlow.com