A claim presented to the controller pursuant to chapter 927, Statutes of 1968, shall be accompanied by a certificate of an authorized representative of the local taxing authority, as follows;

I hereby certify under penalty of perjury that I am a duly appointed, qualified and acting officer of the herein named local taxing authority; that the within claim is based upon the records of assessed valuation and applicable tax rates for said local taxing authority and is in all respects true, correct, and in accordance with law; and that I have not violated any of the provisions of Government Code Sections 1090-1096, inclusive.