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California <br />CL California Cooperative Liquid Assets Securities System <br />P Q Y <br />Participant Representation Form <br />Participant Information <br />Entity Name (Participant) <br />Participant Representations <br />The undersigned Authorized Signer for the Participant hereby represents and warrants the following during the period <br />the Participant is investing in the California CLASS Investment Program: <br />• The Participant is (1) a Public Agency (as defined in the Joint Exercise of Powers Agreement) and (2)(a) a <br />political subdivision of the State of California or (b) an organization whose income is excluded from taxable gross <br />income under Section 115 of the Internal Revenue Code, in each case, that has the authority to invest funds in <br />its treasury in investments in accordance with Section 53601 of the California Government Code. <br />• The Participant is authorized to invest in the California CLASS. <br />• Any Authorized Signer for the Participant designated in this California CLASS Registration Packet has full power <br />and authority to make investments for the above Participant in the California CLASS Investment Program unless <br />the California CLASS receives written notice from the Participant otherwise. <br />• The Participant has reviewed and agrees to the limitations described in the Joint Exercise of Powers Agreement <br />and the Information Statements for the Funds within the California CLASS Investment Program and <br />acknowledges that it has been supplied with or been given access to information it requested in connection with <br />making an investment in the California CLASS Investment Program. <br />• The Participant has reviewed the Investment Policies for the Funds within the California CLASS Investment <br />Program and has determined that they are consistent with the legal and policy limitations applicable to the <br />Participant's investments. <br />• The Participant has consulted with its own counsel and advisers as to all matters concerning investment in the <br />California CLASS Investment Program. <br />Authorized Signer <br />Signature Date <br />Print Name Title <br />Many factors affect performance including changes in market conditions and interest rates and in response to other economic, political, or financial developments. Investment <br />involves risk including the possible loss of principal. No assurance can be given that the performance objectives of a given strategy will be achieved. Past <br />performance is no guarantee of future results. Any financial and/or investment decision may incur losses. <br />717 17th Street, Suite 1850 T (877) 930-5213 clientservices@caIiforniaclass.com <br />Denver, Colorado 80202 F (877) 930-5214 www.californiaclass.com <br />Page 4 <br />